Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects

Abstract

Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.

Enhancing Asthma Patients' Self-Management through Smartphone-Based Application: Design, Usability Evaluation, and Educational Intervention

“…In brief, a checklist was constructed to determine the information content and functionalities of the asthma self-management application based on the selected guideline from the previous stage and a systematic review conducted by the authors in this field. 28 The content validity of the checklist confirmed separately by specialists in the field of health information management (two people), nurse (eight people), and asthma and allergy specialists (five people). The minimum acceptable Content Validity Ratio (CVR) value for 15 participants was 0.42 based on the Lawshe's table and 0.79 for the Content Validity Index (CVI).…”

“…With regard to the importance of training in daily asthma management, and the role of mobile applications in improving self-management, [28][29][30] and also the lack of reliable information in these applications, [23][24][25] designing an evidence-based application to promote self-management seems to be necessary. Therefore, the aim of this study was to design a mobile application based on the guideline, evaluate its usability by performing user evaluation, and examine its effects on their knowledge.…”

Clinicians' Values and Preferences for Medication Adherence and Cost Clinical Decision Support in Primary Care: A Qualitative Study

“…Health systems should consider the appropriateness of other solutions both internal and external to the EHR, such as text reminders or behavioral nudges sent to patients. [7][8][9][10]…”

“…[1][2][3][4] Approximately 20 to 30% of antihypertensive, antihyperlipidemic, antihyperglycemic prescriptions, and other chronic medications are never filled, and 50% are not taken as prescribed. [5][6][7][8][9][10] Additionally, 19% of patients intentionally miss or halve medications to reduce prescription costs. 11 In practice, clinicians tend to overestimate medication adherence and underestimate the proportion of patients with cost barriers.…”

A randomized controlled trial of a mobile application‐assisted nurse‐led model used to improve treatment outcomes in children with asthma

“…Previous studies have demonstrated that the quality of asthma care provided by specially trained asthma nurses (nurse-led asthma care) was equal to that provided by physicians, with an additional advantage of reducing medical expenses (Kamps et al, 2004;Kuethe, Vaessen-Verberne, Elbers, & Van Aalderen, 2013). Studies also showed that appropriate asthma management measures to ensure patient treatment adherence could significantly improve clinical outcomes for children with asthma (Farzandipour, Nabovati, Sharif, Arani, & Anvari, 2017; Global Initiative for Asthma, 2017; Morton et al, 2017). Computer and internet applications are more frequently applied in health care these days and asthma management programs adopting technological interventions to encourage patient engagement could improve asthma management (Arnold, Stingone, & Claudio, 2012;Katwa & Rivera, 2018;Morita et al, 2019;Trivedi, 2015;Voorend-van Bergen et al, 2015).…”