Evidence-Based Review of Smartphone Versus Paper Asthma Action Plans on Asthma Control

Murphy, Julie A.; Heisser, Jennifer M.; Montgomery, M.

doi:10.1177/8755122519830446

Cited by 8 publications

(4 citation statements)

References 22 publications

(51 reference statements)

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“…Nevertheless, action plans are sub-optimally implemented into clinical practice by both general practitioners and allergy specialists [67]. In this context, individualized action plans in a mobile (m) app format were more applicable to adolescents with asthma, resulting in improved disease control [68,69].…”

Section: Assessment Tools For Remote Patient Monitoringmentioning

confidence: 99%

Tele-Monitoring Applications in Respiratory Allergy

Aggelidis,

Kritikou,

Makris

et al. 2024

JCM

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Respiratory allergic diseases affect over 500 million people globally and pose a substantial burden in terms of morbidity, mortality, and healthcare costs. Restrictive factors such as geographical disparities, infectious pandemics, limitations in resources, and shortages of allergy specialists in underserved areas impede effective management. Telemedicine encompasses real-time visits, store-and-forward option triage, and computer-based technologies for establishing efficient doctor-patient communication. Recent advances in digital technology, including designated applications, informative materials, digital examination devices, wearables, digital inhalers, and integrated platforms, facilitate personalized and evidence-based care delivery. The integration of telemonitoring in respiratory allergy care has shown beneficial effects on disease control, adherence, and quality of life. While the COVID-19 pandemic accelerated the adoption of telemedicine, certain concerns regarding technical requirements, platform quality, safety, reimbursement, and regulatory considerations remain unresolved. The integration of artificial intelligence (AI) in telemonitoring applications holds promise for data analysis, pattern recognition, and personalized treatment plans. Striking the balance between AI-enabled insights and human expertise is crucial for optimizing the benefits of telemonitoring. While telemonitoring exhibits potential for enhancing patient care and healthcare delivery, critical considerations have to be addressed in order to ensure the successful integration of telemonitoring into the healthcare landscape.

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Section: Assessment Tools For Remote Patient Monitoringmentioning

confidence: 99%

Tele-Monitoring Applications in Respiratory Allergy

Aggelidis,

Kritikou,

Makris

et al. 2024

JCM

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“…Twenty-two studies showed significant asthma-related symptom reduction [8,14,98,290], whereas 9 studies showed no effect of the intervention on asthma symptoms [52,194,202,[291][292][293][294][295][296]. Larger effects on asthma symptoms were reported when children had uncontrolled asthma at baseline [189,211,297].…”

Section: Symptomsmentioning

confidence: 99%

eHealth Technologies for Monitoring Pediatric Asthma at Home: Scoping Review

Kamp¹,

Hengeveld²,

Brusse-Keizer³

et al. 2023

J Med Internet Res

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Background eHealth monitoring technologies offer opportunities to more objectively assess symptoms when they appear in daily life. Asthma is the most common chronic disease in childhood with an episodic course, requiring close follow-up of pediatric asthma control to identify disease deterioration, prevent exacerbations, and enhance quality of life. eHealth technologies in pediatric asthma care show promising results regarding feasibility, acceptability, and asthma-related health outcomes. However, broad systematic evaluations of eHealth technologies in pediatric asthma are lacking. Objective The objective of this scoping review was to identify the types and applications of eHealth technologies for monitoring and treatment in pediatric asthma and explore which monitoring domains show the most relevance or potential for future research. Methods A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic and comprehensive search was performed on English papers that investigated the development, validation, or application of eHealth technologies for home monitoring or treatment of pediatric asthma in the following databases: PubMed, Cochrane Library, IEEE, Scopus, CINAHL, PsycINFO, and ACM Digital Library. Two authors independently assessed eligibility and extracted data. Data were presented by a descriptive analysis of characteristics and a narrative report for each eHealth domain. Results The review included 370 manuscripts. The following 10 monitoring domains were identified: air quality, airway inflammation markers, lung function, physical activity, sleep, audiovisual, other physiological measurements, questionnaires, medication monitoring, and digital environment (ie, digital platforms, applications, websites, and software tools to monitor or support monitoring). Rising numbers of studies were seen, and the numbers accelerated in the last few years throughout most domains, especially medication monitoring and digital environment. Limited studies (35/370, 9.5%) of multiparameter monitoring strategies, using three or more domains, were found. The number of monitoring validation studies remained stable, while development and intervention studies increased. Intervention outcomes seemed to indicate the noninferiority and potential superiority of eHealth monitoring in pediatric asthma. Conclusions This systematic scoping review provides a unique overview of eHealth pediatric asthma monitoring studies, and it revealed that eHealth research takes place throughout different monitoring domains using different approaches. The outcomes of the review showed the potency for efficacy of most monitoring domains (especially the domains of medication monitoring, lung function, and digital environment). Future studies could focus on modifying potentially relevant hospital-based diagnostics for the home setting to investigate potential beneficial effects and focus on combining home-monitoring domains to facilitate multiparameter decision-making and personalized clinical decision support.

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“…These rates of exacerbations were similar between our 2 groups of participants; thus, DAP provision did not nudge the patients to seek help. Systematic reviews of smartphone self-management apps and tablet self-management applications for asthma available in 2013 and 2019, respectively, suggested that the current evidence was insufficient to make clinical recommendations [12,28]. We initially hypothesized that the DAP might decrease UMCs for 2 reasons.…”

Section: Comparison With Prior Workmentioning

confidence: 99%

“…In 2012, 103 English-language smartphone apps for asthma were available, including 56 apps that provided only information on asthma in general and 47 apps that provided information on asthma management [9]. Previous randomized controlled trials of mobile phone apps for asthma self-monitoring focused on asthma control [10][11][12][13][14]. None provided detailed instructions on the use of rescue medications for the self-management of acute asthma exacerbations with the goal of decreasing UMCs.…”

Section: Introductionmentioning

confidence: 99%

Digital Action Plan (Web App) for Managing Asthma Exacerbations: Randomized Controlled Trial

Beydon¹,

Taillé²,

Corvol³

et al. 2023

J Med Internet Res

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Background A written action plan (WAP) for managing asthma exacerbations is recommended. Objective We aimed to compare the effect on unscheduled medical contacts (UMCs) of a digital action plan (DAP) accessed via a smartphone web app combined with a WAP on paper versus that of the same WAP alone. Methods This randomized, unblinded, multicenter (offline recruitment in private offices and public hospitals), and parallel-group trial included children (aged 6-12 years) or adults (aged 18-60 years) with asthma who had experienced at least 1 severe exacerbation in the previous year. They were randomized to a WAP or DAP+WAP group in a 1:1 ratio. The DAP (fully automated) provided treatment advice according to the severity and previous pharmacotherapy of the exacerbation. The DAP was an algorithm that recorded 3 to 9 clinical descriptors. In the app, the participant first assessed the severity of their current symptoms on a 10-point scale and then entered the symptom descriptors. Before the trial, the wordings and ordering of these descriptors were validated by 50 parents of children with asthma and 50 adults with asthma; the app was not modified during the trial. Participants were interviewed at 3, 6, 9, and 12 months to record exacerbations, UMCs, and WAP and DAP use, including the subjective evaluation (availability and usefulness) of the action plans, by a research nurse. Results Overall, 280 participants were randomized, of whom 33 (11.8%) were excluded because of the absence of follow-up data after randomization, leaving 247 (88.2%) participants (children: n=93, 37.7%; adults: n=154, 62.3%). The WAP group had 49.8% (123/247) of participants (children: n=45, 36.6%; mean age 8.3, SD 2.0 years; adults: n=78, 63.4%; mean age 36.3, SD 12.7 years), and the DAP+WAP group had 50.2% (124/247) of participants (children: n=48, 38.7%; mean age 9.0, SD 1.9 years; adults: n=76, 61.3%; mean age 34.5, SD 11.3 years). Overall, the annual severe exacerbation rate was 0.53 and not different between the 2 groups of participants. The mean number of UMCs per year was 0.31 (SD 0.62) in the WAP group and 0.37 (SD 0.82) in the DAP+WAP group (mean difference 0.06, 95% CI −0.12 to 0.24; P=.82). Use per patient with at least 1 moderate or severe exacerbation was higher for the WAP (33/65, 51% vs 15/63, 24% for the DAP; P=.002). Thus, participants were more likely to use the WAP than the DAP despite the nonsignificant difference between the action plans in the subjective evaluation. Median symptom severity of the self-evaluated exacerbation was 4 out of 10 and not significantly different from the symptom severity assessed by the app. Conclusions The DAP was used less often than the WAP and did not decrease the number of UMCs compared with the WAP alone. Trial Registration ClinicalTrials.gov NCT02869958; https://clinicaltrials.gov/ct2/show/NCT02869958

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Evidence-Based Review of Smartphone Versus Paper Asthma Action Plans on Asthma Control

Cited by 8 publications

References 22 publications

Tele-Monitoring Applications in Respiratory Allergy

Tele-Monitoring Applications in Respiratory Allergy

eHealth Technologies for Monitoring Pediatric Asthma at Home: Scoping Review

Digital Action Plan (Web App) for Managing Asthma Exacerbations: Randomized Controlled Trial

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