Rishi J Khusial1, Persijn J Honkoop2, Omar Usmani3, Marcia Soares4, Andrew Simpson4, Martyn Biddiscombe3, Sally Meah3, Matteo Bonini3, Antonios Lalas5, Eleftheria Polychronidou5, Julia G Koopmans6, Konstantinos Moustakas7, Jiska B Snoeck-Stroband2, Steffen Ortmann8, Konstantinos Votis5, Dimitrios Tzovaras5, Kian Fan Chung3, Stephen Fowler4, Jacob K Sont2. 1. Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: R.J.Khusial@lumc.nl. 2. Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands. 3. Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom. 4. Division of Infection, Immunity and Respiratory Medicine, NIHR Manchester Biomedical Research Centre (BRC), University of Manchester, Manchester, United Kingdom; Manchester University NHS Foundation Trust - Wythenshawe Hospital, Manchester, United Kingdom. 5. Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece. 6. Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands. 7. Electrical and Computer Engineering Department, University of Patras, Rion-Patras, Greece. 8. IHP - Leibniz-Institut für innovative Mikroelektronik, Frankfurt (Oder), Germany.
Abstract
BACKGROUND: Self-management programs have beneficial effects on asthma control, but their implementation in clinical practice is poor. Mobile health (mHealth) could play an important role in enhancing self-management. OBJECTIVE: To assess the clinical effectiveness and technology acceptance of myAirCoach-supported self-management on top of usual care in patients with asthma using inhalation medication. METHODS: Patients were recruited in 2 separate studies. The myAirCoach system consisted of an inhaler adapter, an indoor air-quality monitor, a physical activity tracker, a portable spirometer, a fraction exhaled nitric oxide device, and an app. The primary outcome was asthma control; secondary outcomes were exacerbations, quality of life, and technology acceptance. In study 1, 30 participants were randomized to either usual care or myAirCoach support for 3 to 6 months; in study 2, 12 participants were provided with the myAirCoach system in a 3-month before-after study. RESULTS: In study 1, asthma control improved in the intervention group compared with controls (Asthma Control Questionnaire difference, 0.70; P = .006). A total of 6 exacerbations occurred in the intervention group compared with 12 in the control group (hazard ratio, 0.31; P = .06). Asthma-related quality of life improved (mini Asthma-related Quality of Life Questionnaire difference, 0.53; P = .04), but forced expiratory volume in 1 second was unchanged. In study 2, asthma control improved by 0.86 compared with baseline (P = .007) and quality of life by 0.16 (P = .64). Participants reported positive attitudes toward the system. DISCUSSION: Using the myAirCoach support system improves asthma control and quality of life, with a reduction in severe asthma exacerbations. Well-validated mHealth technologies should therefore be further studied.
RCT Entities:
BACKGROUND: Self-management programs have beneficial effects on asthma control, but their implementation in clinical practice is poor. Mobile health (mHealth) could play an important role in enhancing self-management. OBJECTIVE: To assess the clinical effectiveness and technology acceptance of myAirCoach-supported self-management on top of usual care in patients with asthma using inhalation medication. METHODS:Patients were recruited in 2 separate studies. The myAirCoach system consisted of an inhaler adapter, an indoor air-quality monitor, a physical activity tracker, a portable spirometer, a fraction exhaled nitric oxide device, and an app. The primary outcome was asthma control; secondary outcomes were exacerbations, quality of life, and technology acceptance. In study 1, 30 participants were randomized to either usual care or myAirCoach support for 3 to 6 months; in study 2, 12 participants were provided with the myAirCoach system in a 3-month before-after study. RESULTS: In study 1, asthma control improved in the intervention group compared with controls (Asthma Control Questionnaire difference, 0.70; P = .006). A total of 6 exacerbations occurred in the intervention group compared with 12 in the control group (hazard ratio, 0.31; P = .06). Asthma-related quality of life improved (mini Asthma-related Quality of Life Questionnaire difference, 0.53; P = .04), but forced expiratory volume in 1 second was unchanged. In study 2, asthma control improved by 0.86 compared with baseline (P = .007) and quality of life by 0.16 (P = .64). Participants reported positive attitudes toward the system. DISCUSSION: Using the myAirCoach support system improves asthma control and quality of life, with a reduction in severe asthma exacerbations. Well-validated mHealth technologies should therefore be further studied.
Authors: Julie Marie Postma; Tamara Odom-Maryon; Ana G Rappold; Hans Haverkamp; Solmaz Amiri; Ross Bindler; Justin Whicker; Von Walden Journal: Public Health Nurs Date: 2021-10-11 Impact factor: 1.462
Authors: Stephanie Dramburg; María Marchante Fernández; Ekaterina Potapova; Paolo Maria Matricardi Journal: Front Immunol Date: 2020-09-10 Impact factor: 7.561