Effect of an mHealth application on clinical outcomes in childhood asthma: Real-world, pragmatic trial in a primary care setting

Abstract

Medical adherence among children with asthma is a challenging problem. Mobile health applications have been increasingly used to improve adherence and clinical outcomes. Here, we compared clinical outcomes by using a mobile health application (Asmon application) with those receiving usual care, assessed the patient’s satisfaction and the usability of this tool. Methods: We conveniently allocated children with persistent asthma aged 4‒15 years and a guardian to receive the Asmon application or a usual care for 6 months. Assessments were performed at baseline and at the 6-month follow-up. Outcomes were the asthma control test score (ACT), dose of inhaled corticosteroids (ICS), acute exacerbation, and asthma-related quality of life. Participants’ satisfaction and reasons for unengaging in long-term use of the application were also analyzed. Results: The overall drop-out rate was 24.1% (intervention 13, 16.5%; control 6, 7.6%). The mean ACT scores had increased in both groups from baseline to the 6 months follow-up (intervention, p < 0.001; control p = 0.001), but did not differ significantly between groups (p = 0.784). Among those with poorly controlled asthma at baseline, the intervention group showed possibly higher improvement than the control (37.5% vs 16.7%) even though the value was not significantly different (p = 0.128). Acute exacerbation, median dose of ICS usage, and asthma-related quality of life were not significantly different between groups (p = 0.554, 0.555, and 0.627, respectively). Approximately one-third of the intervention group never used the application, while 40.5% ever used only 1‒7 times during the study period. Perception regarding the application was hard-to-use, self-judged ICS discontinuation, and change in guardians were the main obstacles for regular engagement. Nevertheless, the satisfaction score on the rating scale was high (4.5/5.0).Conclusion: The interactive Asmon application potentially improved disease control only in children with poorly controlled asthma at baseline. Acute exacerbation rate, dose of ICS, and asthma-related quality of life were not impacted by the intervention. Healthcare providers should thoroughly consider participants’ and guardians’ background characteristics before implementing an mHealth application in the real-world daily practices.

Evaluasi Penggunaan Aplikasi Smartphone Sebagai Media Manajemen Mandiri Untuk Mencegah Kekambuhan Pada Pasien Asma: Systematic Review

“…Aplikasi Asmon yang disusun oleh Songnuy et al, (2022) kemudian dikembangkan oleh pakar IT. Pada kunjungan pertama, peneliti memberi tahu subjek tentang tujuan, manfaat aplikasi dan cara menggunakan aplikasi asmon.…”

“…Penelitian yang dilakukan oleh Songnuy et al, (2022) tentang penggunaan aplikasi Asmon pada anak yang didiagnosis asma. Penelitian ini dilakukan di Thailand pada tahun 2020.…”