Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their use and mitigate potential harms. Objective To report the characteristics and features of publicly available apps for COPD self-management. Methods MHealth apps designed for patients’ COPD self-management were searched in the Google Play and Apple app stores. Two reviewers trialed and assessed the eligible apps using the MHealth Index and Navigation Database framework to describe the characteristics, qualities, and features of mHealth apps across five domains. Results From the Google Play and Apple stores, thirteen apps were identified and eligible for further evaluation. All thirteen apps were available for Android devices, but only seven were available for Apple devices. Most apps were developed by for-profit organizations (8/13), non-profit organizations (2/13), and unknown developers (3/13). Many apps had privacy policies (9/13), but only three apps described their security systems and two mentioned compliance with local health information and data usage laws. Education was the common app feature; additional features were medication reminders, symptom tracking, journaling, and action planning. None provided clinical evidence to support their use. Conclusions Publicly available COPD apps vary in their designs, features, and overall quality. These apps lack evidence to support their clinical use and cannot be recommended at this time.
Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps’ designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework ( https://mindapps.org/ ), a tool designed to help clinicians determine the best mHealth apps to address patients’ needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration : PROSPERO (CRD42021260205). Supplementary Information The online version contains supplementary material available at 10.1007/s13721-023-00419-0.
BACKGROUND Interactive, digital self-management (IDSM) interventions may help individuals with chronic respiratory disease manage their condition. OBJECTIVE The aim of this review was to summarize the characteristics and effectiveness of IDSM interventions for individuals with chronic respiratory diseases. METHODS Reviewers screened titles, abstracts, and full texts of studies featuring: 1) applications or wearable devices for IDSM, 2) randomized controlled trials, and 3) adults with chronic respiratory disease. Articles were excluded if they were not available in English, French, or Portuguese. Study and intervention characteristics and outcomes were extracted. A meta-analysis was conducted for outcomes with combinable data. RESULTS The search generated 93,419 studies. Twenty-four trials were included in the qualitative synthesis and 17 in the quantitative synthesis. Studies evaluated 1726 individuals with asthma and 1265 individuals with chronic obstructive pulmonary disease (COPD; FEV1 %predicted 36 to 69). In asthma, median (range) intervention length was 12 (8-52) weeks. In COPD, median (range) intervention length was 24 (2-48) weeks. Meta-analysis for COPD studies showed IDSM interventions had a greater effect than control for health status (COPD Assessment Test score mean difference [95%CI]: -2.7 [-4.3, -1.2], P < .01) and physical activity (steps per day: 627.65 [95%CI 104.23, 1151.06], P = .02). Meta-analysis for asthma studies examined asthma control. No effect greater was found for asthma control test (0.55 [95% CI -1.90, 3.00], P = .66) or asthma control questionnaire (2.80 [95% CI -0.08, 0.64], P = .12). Evidence quality ranged from very low to moderate. CONCLUSIONS This review outlined the effectiveness and characteristics of IDSM interventions for chronic respiratory disease. Interventions were heterogeneous and studies yielded very low to moderate quality evidence. For COPD, IDSM benefitted health status and physical activity. Improvements in design of IDSM interventions will assist clinicians to identify those best suited to improve health in individuals with respiratory conditions.
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