Summary of findings 3. Feedback device compared with control versus usual care for people with asthma.
| Feedback device compared with control/usual care for people with asthma | |||||||
| Patient or population: adults and children with asthma Setting: primary and secondary care Intervention: feedback device Comparison: control/usual care | |||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | ||
| Risk with control/usual care | Risk with feedback device | ||||||
|
Correct inhaler technique 4‐Week follow‐up |
Adults | 51 per 100 |
83 per 100 (66 to 93) |
OR 4.80 (1.87 to 12.33) | 97 (1 RCT) |
⊕⊕⊝⊝ LOWa,b |
Additional results from technique rating scales could not be combined (Analysis 5.3) |
|
Inhaler technique (PIF) Follow‐up: 6 weeks (adults) 6 to 12 weeks (children) |
Adults | 66 per 100 | 97 per 100 (81 to 100) | OR 18.26 (2.22 to 150.13) | 71 (1 RCT) | ⊕⊕⊝⊝ LOWa,b |
|
| Children | Mean PIF was 51.2 litres/min | Mean PIF was 9.22 litres/min better (33.71 better to 15.27 worse) | ‐ | 98 (2 RCTs) | ⊕⊕⊝⊝ LOWa,c |
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|
Asthma control (ACQ) 6 to 12 weeks |
Adults | Mean ACQ score was 1.4 | Mean score in the intervention group was 0.1 better (0.46 better to 0.26 worse) |
‐ | 97 (1 RCT) |
⊕⊕⊝⊝ LOWa,c |
|
| Children | Mean ACQ score was 0.7 | Mean score in the intervention group was 0.02 worse (0.35 worse to 0.32 better) | ‐ | 98 (2 RCTs) | ⊕⊕⊕⊝ MODERATEa |
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|
Quality of life Follow‐up: 6 weeks (adults) 6 to 12 weeks (children) |
Adults | Mean score on the mini‐AQLQ was 4.2 | Mean score in the intervention group was 0.38 better (0.01 worse to 0.77 better) | ‐ | 100 (2 RCTs) | ⊕⊕⊝⊝ LOWa,d |
|
| Children | Mean change in quality of life was 0.07 | Mean change was 0.25 better (0.07 worse to 0.58 better) | ‐ | 91 (2 RCTs) | ⊕⊕⊝⊝ LOWa,d |
One study reported endpoint quality of life (Analysis 6.4) | |
|
Quality of life (responders) 6 weeks |
Adults | 49 per 100 | 83 per 100 (62 to 94) | OR 5.29 (1.76 to 15.89) | 71 (1 RCT) | ⊕⊕⊕⊝ MODERATEa |
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| Other outcomes | No results could be analysed for exacerbations, adverse events, unscheduled visits to a healthcare provider or school/work absences | ||||||
| *The risk in the intervention group (and its 95% confidence interval) is based on assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) ACQ: Asthma Control Questionnaire (range 0 to 6; lower is better); CI: confidence interval; OR: odds ratio; PIF: peak inspiratory flow; RCT: randomised controlled trial; RR: risk ratio; SDs: standard deviations | |||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to the estimate of effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||||
aHigh risk of performance and detection bias. Downgraded once
bVery wide confidence intervals based on one study. Downgraded once
cConfidence intervals include possible harm and benefit of the intervention. Downgraded once
dConfidence interval does not exclude no difference, and upper limit exceeds the MCID of 0.5 units. Downgraded once