Non-pharmacological interventions for asthma prevention and management across the life course: Umbrella review

IF 4.6 2区医学 Q2 ALLERGY Clinical and Translational Allergy Pub Date : 2024-02-29 DOI:10.1002/clt2.12344

Xunliang Tong, Xinyue Zhang, Mengyuan Wang, Zijun Wang, Fawu Dong, Enying Gong, Torsten Zuberbier, Yanming Li

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Abstract

Background

The impact of non-pharmacological interventions (NPIs) on asthma prevention and management is insufficiently examined. We aim to comprehensively evaluate and synthesize existing evidence regarding the effectiveness of various NPIs throughout the life course.

Methods

We conducted a systematic search and screening of reviews that examined the effectiveness of various NPIs on asthma prevention and control in the Cochrane Library, PubMed, Embase, and Ovid databases. Data extraction was performed by considering the type of NPIs and the life course stages of the target population. Recommendations were provided by considering the quality of review assessed using the AMSTAR2 tool and the consistency of findings across reviews.

Results

We identified 145 reviews and mapped the evidence on the impact of 25 subtypes of NPIs on asthma prevention and control based on five stages of life course. Reviews indicated a shift of focus and various impacts of major NPIs on asthma prevention and control across life courses, while a few types of NPIs, such as physical exercise, appeared to be beneficial in children, adolescents and adults. Consistent and high-level evidence was observed only for psychological intervention on asthma control and quality of life among adults and older adults. Potential benefit with high-level evidence was reported on certain NPIs, such as vitamin D in reducing risk of developing asthma in offsprings in the prenatal stage, digital health interventions in improving asthma control from childhood to older adulthood, and breathing exercise in improving quality of life, asthma-related symptoms and lung function in adulthood and older adulthood.

Conclusion

This study emphasizes the significance of delivering NPIs to improve asthma prevention and management and highlights the heterogeneity regarding the impact of NPIs across life courses. High-quality research is urgently needed to further strengthen the evidence base of NPIs and tailored interventions should be considered in guideline development.

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在整个生命过程中对哮喘的预防和管理采取非药物干预措施：综述。

背景：非药物干预（NPI）对哮喘预防和管理的影响尚未得到充分研究。我们的目的是全面评估和综合现有证据，了解各种非药物干预措施在整个生命过程中的有效性：我们在 Cochrane Library、PubMed、Embase 和 Ovid 数据库中对研究各种 NPI 对哮喘预防和控制效果的综述进行了系统检索和筛选。提取数据时考虑了 NPI 的类型和目标人群的生命过程阶段。通过考虑使用 AMSTAR2 工具评估的综述质量以及各篇综述结论的一致性，提出建议：结果：我们确定了 145 篇综述，并根据生命历程的五个阶段对 25 种亚型非哮喘药物对哮喘预防和控制的影响进行了证据分析。综述表明，在不同的生命历程中，主要非营利性哮喘防治措施的重点有所转移，对哮喘防治的影响也各不相同，而体育锻炼等少数几种非营利性哮喘防治措施似乎对儿童、青少年和成人都有益处。只有心理干预对成人和老年人的哮喘控制和生活质量有一致的高水平证据。某些非哮喘干预措施的潜在益处具有高级别证据，如维生素 D 在产前阶段可降低后代患哮喘的风险，数字健康干预措施可改善儿童期至成年期的哮喘控制，呼吸运动可改善成年期和老年期的生活质量、哮喘相关症状和肺功能：本研究强调了提供非哮喘治疗方案对改善哮喘预防和管理的重要意义，并突出了非哮喘治疗方案在不同生命过程中产生的不同影响。目前急需开展高质量的研究，进一步加强 NPIs 的证据基础，在制定指南时应考虑量身定制的干预措施。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.