Effectiveness of home visits in adult patients with asthma: a systematic review of randomized controlled trials.

Abstract Background The effectiveness of home visits is well discussed for children with asthma, but limited in adults. Objective The present systematic review aims to investigate the potential role of home visits in improving outcomes among adult patients with asthma. Methods The systematic review was performed in line with the PRISMA statement. An extensive literature search was conducted using databases such as PubMed, ProQuest, CINAHL, The Cochrane Library, PsycINFO, and Google Scholar from inception to June 2019. The studies included were randomized controlled trials (RCTs), which reported asthma outcomes in adult patients. Results The literature search yielded 8331 publications, of which 63 studies were selected for full-text review, and of these studies, 9 studies with a total of 2011 patients were included in the final analysis. The included RCTs reported quality of life (QoL), asthma symptoms, exacerbations, healthcare utilization, and pulmonary function. Improvements in asthma outcomes were observed predominantly in QoL. The effects on asthma symptom control were inconsistent. The evidence on the impact of home visits in asthma exacerbations and healthcare utilization was rather limited. There were no significant differences observed between intervention versus control arms in terms of pulmonary function; however, one study reported significant improvements in PEFR. Conclusion Home visits may serve as an adjuvant activity that complements existing healthcare system based initiatives. It may be concluded that home visits have the potential to improve outcomes in adult patients with asthma; however, the RCTs reviewed in the present systematic review reported several limitations that warrant further investigation.