Effectiveness of myAirCoach: A mHealth Self-Management System in Asthma.

App Asthma Personalized care Quality of life Self-management Telemedicine eHealth mHealth

Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
06 2020
Historique:
received: 11 11 2019
revised: 14 01 2020
accepted: 10 02 2020
pubmed: 7 3 2020
medline: 15 5 2021
entrez: 7 3 2020
Statut: ppublish

Résumé

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. 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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 32142961
pii: S2213-2198(20)30178-1
doi: 10.1016/j.jaip.2020.02.018
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1972-1979.e8

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Rishi J Khusial (RJ)

Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: R.J.Khusial@lumc.nl.

Persijn J Honkoop (PJ)

Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.

Omar Usmani (O)

Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom.

Marcia Soares (M)

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.

Andrew Simpson (A)

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.

Martyn Biddiscombe (M)

Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom.

Sally Meah (S)

Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom.

Matteo Bonini (M)

Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom.

Antonios Lalas (A)

Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece.

Eleftheria Polychronidou (E)

Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece.

Julia G Koopmans (JG)

Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.

Konstantinos Moustakas (K)

Electrical and Computer Engineering Department, University of Patras, Rion-Patras, Greece.

Jiska B Snoeck-Stroband (JB)

Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.

Steffen Ortmann (S)

IHP - Leibniz-Institut für innovative Mikroelektronik, Frankfurt (Oder), Germany.

Konstantinos Votis (K)

Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece.

Dimitrios Tzovaras (D)

Information Technologies Institute, Centre for Research and Technology - Hellas (CERTH), Thessaloniki, Greece.

Kian Fan Chung (KF)

Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom.

Stephen Fowler (S)

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.

Jacob K Sont (JK)

Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.

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