Comparative Effectiveness Review
                                     Number 71
             Breathing Exercises
             and/or Retraining
             Techniques in the
             Treatment of Asthma:
             Comparative Effectiveness
         Comparative Effectiveness Review 
         Number 71 
          
          
         Breathing Exercises and/or Retraining Techniques in 
         the Treatment of Asthma: Comparative Effectiveness 
          
          
          
         Prepared for:  
         Agency for Healthcare Research and Quality 
         U.S. Department of Health and Human Services 
         540 Gaither Road 
         Rockville, MD 20850 
         www.ahrq.gov 
          
         Contract No. 290-2007-10057-I 
          
         Prepared by: 
         Oregon Evidence-based Practice Center 
         Kaiser Permanente Center for Health Research 
         Portland, OR 
          
          
          
         Investigators: 
         Elizabeth O’Connor, Ph.D. 
         Carrie D. Patnode, Ph.D., M.P.H. 
         Brittany U. Burda, M.P.H. 
         David I. Buckley, M.D., M.P.H. 
         Evelyn P. Whitlock, M.D., M.P.H. 
          
          
          
          
          
          
         AHRQ Publication No. 12-EHC092-EF 
         September 2012 
                                    
       This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) 
       under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD 
       (Contract No. 290-2007-10057-I). The findings and conclusions in this document are those of the 
       authors, who are responsible for its contents; the findings and conclusions do not necessarily 
       represent the views of AHRQ. Therefore, no statement in this report should be construed as an 
       official position of AHRQ or of the U.S. Department of Health and Human Services. 
        
       The information in this report is intended to help health care decisionmakers—patients and 
       clinicians, health system leaders, and policymakers, among others—make well-informed 
       decisions and thereby improve the quality of health care services. This report is not intended to 
       be a substitute for the application of clinical judgment. Anyone who makes decisions concerning 
       the provision of clinical care should consider this report in the same way as any medical 
       reference and in conjunction with all other pertinent information, i.e., in the context of available 
       resources and circumstances presented by individual patients. 
        
       This report may be used, in whole or in part, as the basis for development of clinical practice 
       guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage 
       policies. AHRQ or U.S. Department of Health and Human Services endorsement of such 
       derivative products may not be stated or implied. 
        
       This document is in the public domain and may be used and reprinted without permission except 
       those copyrighted materials noted for which further reproduction is prohibited without the 
       specific permission of copyright holders. 
        
       Persons using assistive technology may not be able to fully access information in the report. For 
       assistance contact EffectiveHealthCare@ahrq.hhs.gov.  
        
       None of the investigators have any affiliations or financial involvement that conflict with the 
       material presented in this report. 
        
       Suggested citation: O’Connor E, Patnode CD, Burda BU, Buckley DI, Whitlock EP. Breathing 
       Exercises and/or Retraining Techniques in the Treatment of Asthma: Comparative Effectiveness. 
       Comparative Effectiveness Review No. 71. (Prepared by the Oregon Evidence-based Practice 
       Center under Contract No. 290-2007-10057-I.) AHRQ Publication No. 12-EHC092-EF. 
       Rockville, MD: Agency for Healthcare Research and Quality. September 2012. 
       www.effectivehealthcare.ahrq.gov/reports/final.cfm. 
        
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              Preface 
                  The Agency for Healthcare Research and Quality (AHRQ) conducts the Effective Health 
              Care Program as part of its mission to organize knowledge and make it available to inform 
              decisions about health care. As part of the Medicare Prescription Drug, Improvement, and 
              Modernization Act of 2003, Congress directed AHRQ to conduct and support research on the 
              comparative outcomes, clinical effectiveness, and appropriateness of pharmaceuticals, devices, 
              and health care services to meet the needs of Medicare, Medicaid, and the Children’s Health 
              Insurance Program (CHIP). 
                  AHRQ has an established network of Evidence-based Practice Centers (EPCs) that produce 
              Evidence Reports/Technology Assessments to assist public- and private-sector organizations in 
              their efforts to improve the quality of health care. The EPCs now lend their expertise to the 
              Effective Health Care Program by conducting Comparative Effectiveness Reviews (CERs) of 
              medications, devices, and other relevant interventions, including strategies for how these items 
              and services can best be organized, managed, and delivered. 
                  Systematic reviews are the building blocks underlying evidence-based practice; they focus 
              attention on the strength and limits of evidence from research studies about the effectiveness and 
              safety of a clinical intervention. In the context of developing recommendations for practice, 
              systematic reviews are useful because they define the strengths and limits of the evidence, 
              clarifying whether assertions about the value of the intervention are based on strong evidence 
              from clinical studies. For more information about systematic reviews, see the Web site 
              http://www.effectivehealthcare.ahrq.gov/reference/purpose.cfm. 
                  AHRQ expects that CERs will be helpful to health plans, providers, purchasers, government 
              programs, and the health care system as a whole. In addition, AHRQ is committed to presenting 
              information in different formats so consumers who make decisions about their own and their 
              family’s health can benefit from the evidence. 
                  Transparency and stakeholder input from are essential to the Effective Health Care Program. 
              Please visit the Web site (www.effectivehealthcare.ahrq.gov) to see draft research questions and 
              reports or to join an email list to learn about new program products and opportunities for input. 
              CERs will be updated regularly. 
                  We welcome comments about this CER. They may be sent by mail to the Task Order Officer 
              named below at: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 
              20850, or by email to epc@ahrq.hhs.gov.  
               
              Carolyn M. Clancy, M.D.                         Stephanie Chang, M.D., M.P.H. 
              Director, Agency for Healthcare Research        Director, Evidence-based Practice Program 
              and Quality                                     Center for Outcomes and Evidence 
                                                              Agency for Healthcare Research and Quality 
              Jean Slutsky, P.A., M.S.P.H.                     
              Director, Center for Outcomes and Evidence      Christine Chang, M.D., M.P.H. 
              Agency for Healthcare Research and Quality      Task Order Officer 
                                                              Center for Outcomes and Evidence 
                                                              Agency for Healthcare Research and Quality
               
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