Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbations.
Bruna F Sebastião, Raquel M Hortelão, Sara S Granadas and 3 others
PMID 38352284WHAT IT FOUND
Vigilance, monitoring, education and policy emerged as possible air-quality self-management approaches for asthma and COPD.
Evidence came from five heterogeneous studies, so these are candidate nursing interventions, not proven treatments.
Key findings
01The review included five studies on air-quality self-management in people with asthma, COPD or both.
02A home indoor environment package involving allergen evaluation, physical parameter measurement, fungal sampling and educational advice, and alert announcements through web notifications and media coverage, were associated with fewer asthma hospitalizations or emergency visits.
03A smoke-free regulation and reduced ambient air pollutants from an action plan were associated with lower COPD admission rates or hospitalization risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 5 articles, and the authors stated that available evidence was limited. The included studies used different interventions, populations and settings. This made it hard to identify the most effective strategy. Cohort studies were rated low to moderate quality, and some studies lacked long-term follow-up. The search was limited to 2017 until 2023, Portuguese, Spanish or English, and Google Scholar returned only the first 100 results. One included study enrolled participants from age 6, although the review specified adults. The included studies were not all nurse-delivered; some used physician visits, home counselors, public alerts or policy changes.
Declared interests
Funding: Nothing to declare. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that nurse-led air-quality self-management is proven to prevent exacerbations. The review included only five heterogeneous studies, and some interventions were multi-component packages, public alerts or policy changes rather than tested nurse-delivered interventions.