Developing and evaluating ASTHMAXcel adventures

Abstract

Background The ASTHMAXcel mobile application has been linked to favorable outcomes among adult patients with asthma. Objective We assessed the impact of ASTHMAXcel Adventures, a gamified, guideline-based, pediatric version on asthma control, knowledge, health care utilization, and patient satisfaction. Methods Pediatric patients with asthma received the ASTHMAXcel Adventures mobile intervention on-site only at baseline (visit 1), 4 months (visit 2), and 6 months (visit 3). The asthma control test, asthma illness representation scale–self-administered, pediatric asthma impact survey, and Client Satisfaction Questionnaire-8 were used to assess asthma control, knowledge, and patient satisfaction. Patients reported the number of asthma-related emergency department (ED) visits, hospitalizations, and oral prednisone use. Results A total of 39 patients completed the study. The proportion of controlled asthma increased from visit 1 to visits 2 and 3 (30.8% vs 53.9%, P = .04; 30.8% vs 59.0%, P = .02), and largely seen in boys. The mean asthma illness representation scale–self-administered scores increased from baseline pre- to postintervention, with sustained improvements at visits 2 and 3 (3.55 vs 3.76, P < .001; 3.55 vs 3.80, P = .001; 3.55 vs 3.99, P < .001). The pediatric asthma impact survey scores improved from baseline to visits 2 and 3 (43.33 vs 34.08, P < .001; 43.33 vs 31.74, P < .001). ED visits and prednisone use significantly decreased from baseline to visits 2 and 3 (ED: 0.46 vs 0.13, P = .03; 0.46 vs 0.02, P = .02; prednisone use, 0.49 vs 0.13, P = .02; 0.49 vs 0.03, P = .003. Satisfaction was high with mean client satisfaction questionnaire score of approximately 30 (out of 32) at all visits. Conclusion ASTHMAXcel Adventures improved asthma control, knowledge, and quality of life, and reduced ED visits and prednisone use with high satisfaction scores.

Where Should Mobile Health Application Providers Focus Their Goals?

“…One part of the study was a group experiment in different populations to demonstrate the effectiveness of mHealth applications for one or several diseases. Such as Brian C, Anjani K. Singh, etc., demonstrated the effect of mobile health applications on asthma by following 39 patients and assessing their impact on asthma-related emergency room visits, hospitalizations, and oral prednisone [27]. XiaodanZhu, MinLi demonstrated mobile health applications can improve compliance with antipsychotic medications in patients with schizophrenia, by grouping 84 discharged patients from the Mental Health Center in Yinchuan, Ningxia hui Autonomous Region, China [28].…”

Technical Factors That May Influence mHealth Adherence in Children With Chronic Pulmonary Diseases: Scoping Review

“…Five studies mentioned that connectivity constitutes a technical factor of mHealth apps that affects the compliance with nonpharmaceutical treatment of pediatric patients with pulmonary diseases. 9,24,28,30,31 Free availability was mentioned by 4 of the studies as a factor that really facilitates the use of mHealth apps by children and adolescents. 24,27,28,32 Furthermore, 4 studies declare that privacy and security issues constitute a technical factor of mHealth apps, significantly affecting the compliance with nonpharmacological treatment of children and adolescents with CPDs, 9,25,29 mentioning cultural readiness as a factor that facilitates the use of mHealth apps by young children (see Supplemental Digital Content 3, available at: http://links.lww.com/ PPT/A490).…”

The Relationship Between Depressive Symptoms, eHealth Literacy, and Asthma Outcomes in the Context of a Mobile Health Intervention

“…In recent years, there has been an increased emphasis on mobile interventions for managing chronic conditions including asthma (16)(17)(18). Mobile health (mHealth) interventions are aimed at targeting individuals with low health literacy to improve asthma knowledge and outcomes (18).…”

“…The patient-facing mobile app used in the current study, ASTHMAXcel, provides asthma education to users. ASTHMAXcel is a novel mHealth application developed in accordance with the National Asthma Education and Prevention Program, Global Initiative for Asthma, and British Thoracic Society/Scottish Intercollegiate Network guidelines (17). The app consists of 10 chapters, each corresponding to a section of the National Asthma Education and Prevention Program guidelines, with 1-to 2-minute animated videos and personalized content (17,18) (Figure 1).…”

“…ASTHMAXcel is a novel mHealth application developed in accordance with the National Asthma Education and Prevention Program, Global Initiative for Asthma, and British Thoracic Society/Scottish Intercollegiate Network guidelines (17). The app consists of 10 chapters, each corresponding to a section of the National Asthma Education and Prevention Program guidelines, with 1-to 2-minute animated videos and personalized content (17,18) (Figure 1). The development and evaluation of the ASTHMAXcel app was conducted through a grant-funded randomized controlled trial (RCT), which adapted, tested, and refined the app for use in primary care settings to aid in collecting and using patient-reported outcome (PRO) measures to improve asthma care and increase patient access to asthma education.…”