Feasibility of a smartphone application based action plan and monitoring in asthma

Abstract

BackgroundAsthma patients may experience acute episodic exacerbation. The guidelines recommend that written action plan should be given to asthma patients. However, no one can predict when and where acute exacerbation will happen. As people carry smart phone almost anytime and anywhere, smartphone application could be a useful tool in asthma care. We evaluated the feasibility of the ubiquitous healthcare system of asthma care using a smartphone application (snuCare) based on the self-management guideline or action plan.MethodsForty-four patients including fragile asthmatics were enrolled from Seoul National University Bundang Hospital between December 2011 and February 2012. They were randomly assigned into application user (n = 22) or application nonuser group (n = 22). We evaluated user-satisfaction, and clinical parameters such as asthma control, Quality of Life Questionnaire for Adult Korean Asthmatics, and the adherence of patients.ResultsThe characteristics were similar at baseline between the 2 groups except those who treated with short-term systemic steroid or increased dose of systemic steroid during previous 8 weeks (user vs. nonuser: 31.8% vs. 4.5%, p = 0.020). Total of 2,226 signals was generated during 8 weeks including 5 risky states. After eight weeks, the users answered that it was very easy to use the application, which was shown in highest scores in terms of satisfaction (mean ± standard deviation, 4.3 ± 0.56). Seventy-three percent of patients answered that the application was very useful for asthma care. User group showed improved the adherence scores (p = 0.017). One patient in application user group could avoid Emergency Department visit owing to the application while a patient in nonuser group visited Emergency Department.ConclusionThe ubiquitous healthcare system using a smartphone application (snuCare) based on the self-management guideline or action plan could be helpful in the monitoring and the management of asthma.

A review of the use and effectiveness of digital health technologies in patients with asthma

“…46 Two of the 3 studies found no effect on clinical assessments of lung function. 46,47 The few adult interventions that included EMDs combined this technology with either an app 50 or an interactive website. 39 One RCT that enrolled 495 adults in the United States and focused on a robust EMD reported a significant decrease in short-acting medication use (change from baseline in mean daily SABA use per person: ¡0.51 for routine care vs ¡0.62 for intervention; P = .004) and improved asthma control in previously uncontrolled patients (change from baseline in percentage of patients with controlled asthma: +49% for routine care vs +63% for intervention; P = .02).…”

“…44 The inconsistent results among these studies may be attributed to differences in study methodology and design (eg, RCT vs observational study), as well as differences in enrolled patient populations. The 5 studies that evaluated mobile apps [45][46][47][48][49] in adult patients reported more consistent benefits in a range of outcomes. The outcomes most commonly found to improve were asthma control, 45,47,49 HRQoL, 46,47,49 and adherence.…”

“…The 5 studies that evaluated mobile apps [45][46][47][48][49] in adult patients reported more consistent benefits in a range of outcomes. The outcomes most commonly found to improve were asthma control, 45,47,49 HRQoL, 46,47,49 and adherence. 46 Two of the 3 studies found no effect on clinical assessments of lung function.…”

“…The outcomes most commonly found to improve were asthma control, 45,47,49 HRQoL, 46,47,49 and adherence. 46 Two of the 3 studies found no effect on clinical assessments of lung function. 46,47 The few adult interventions that included EMDs combined this technology with either an app 50 or an interactive website.…”

“…35,51 Across all of these studies, satisfaction with the intervention and perceptions of effectiveness were high. Five studies in adults 45,46,[48][49][50] reported data pertaining to patients' perceptions of the DHT intervention. Like the pediatric studies, satisfaction with the intervention among adult patients was high, and most patients indicated they would recommend the technology to a friend or family member.…”