Therapeutic strategies, health status and quality of life among persons with asthma: A meta-analysis

Abstract

Asthma is a major health problem that affects approximately 17 million people in the United States. Unique circumstances associated with a patient's health status have made evaluations of the management of asthma difficult. The purposes of the study were to assemble information on therapeutic strategies, health status factors and Quality of Life among persons with asthma and make empirical generalizations about the selected variables from a universe of studies.

This meta-analytical investigation consisted of fifteen subject studies that used experimental strategies and the Asthma Quality of Life Questionnaire on asthmatic subjects. Four research questions asked: (a) What are the substantive characteristics of health status in the sample of studies? (b) What are the substantive and methodological characteristics of therapeutic strategies in the sample of studies? (c) What are the contributions of health status and therapeutic strategies to the magnitude of quality of life among persons with asthma in the sample of studies? and, (d) What is the influence of health status and therapeutic strategies on QOL among persons with asthma?

Indicators of health status factors were identified and categorized. Of twelve anticipated categories, emotional/psychological, environmental and spiritual factors were not studied. Therapeutic strategies were primarily pharmacological clinical trials. Meta-analytical findings of three studies in which Zileuton and Salmeterol were studied supported that combined effect sizes yielded statistically significant improvement in perceptions of activity limitations, symptoms, emotional, environmental concerns and overall quality of life. A binomial effect size display indicated a 58% improvement in overall quality of life. Sample size and missing data hampered analyses of potential moderator variables associated with the findings. A path analysis of effect sizes suggested therapeutic strategies and the health status factors had small positive total effects that ranged from r = 0.15 to r = 0.16 on overall quality of life, activity limitations and symptoms. Total effects ranged from r = 0.09 to r = 0.16 for emotional concerns and r = 0.11 to r = 0.14 for environmental concerns.