Acceptance and Dropout Rates of Individuals with Asthma Approached in Self-management Interventions: A Systematic Review and Meta-analysis

The objectives of this systematic review were to assess the acceptability of self-management interventions for people with asthma and identify contributing factors. A systematic literature search was conducted using PubMed, MEDLINE, EMBASE (OVIDWEB), CINAHL and Cochrane databases. Clinical trials design was included if they met specified criteria. A random-effect meta-regression analysis was conducted to estimate the overall acceptance and drop-out rates and to assess the potential factors that may influence the outcomes. A total of 64 studies were included and 8,092 participants were recruited and participated in the trials. The estimated acceptance rate was 51.1%, while the estimated drop-out rates in the intervention and control groups were 18.2% and 15.6%, respectively. Lack of interest was the main reported reason for refusing to participate and dropping out from the program. Study-related and program-related factors influenced the acceptance and drop-out rates statistically and clinically. The acceptance rate of self-management programs among asthmatic people was not high and the dropout rate was somewhat low. The review suggests optimizing the design of self-management studies and modifying the implemented self-management programs to increase the acceptance rate and decrease the dropout rate.