The evolution of mobile apps for asthma: an updated systematic assessment of content and tools

Abstract

BackgroundInterest in mobile apps that support long-term conditions such as asthma is matched by recognition of the importance of the quality and safety of apps intended for patient use. We assessed how changes over a 2-year period affected the clinical suitability of apps providing self-management information and tools for people with asthma by updating a review first performed in 2011.MethodsSystematic content assessment of all apps for iOS and Android examining the comprehensiveness of asthma information, consistency with the evidence base for asthma self-management and adherence to best practice principles for trustworthy content, comparing the quality of apps available in 2011 to those released since.ResultsBetween 2011 and 2013, numbers of asthma apps more than doubled from 93 to 191, despite withdrawal of 25% (n = 23/93) of existing apps. Newer apps were no more likely than those available in 2011 to include comprehensive information, such as the use of action plans, or offer guidance consistent with evidence; 13% (n = 19/147) of all apps, and 39% (n = 9/23) of those intended to manage acute asthma, recommended self-care procedures unsupported by evidence. Despite increases in the numbers of apps targeting specific skills, such as acute asthma management (n = 12 to 23) and inhaler technique (from n = 2 to 12), the proportion consistent with guidelines (17%, n = 4/23) and inhaler instructions (25%, n = 3/12), respectively, was low, and most apps provided only either basic information about asthma (50%, n = 75/147) or simple diary functions (24%, n = 36/147).ConclusionsIn addition to persisting questions about clinical quality and safety, dynamic aspects of app turnover and feature evolution affect the suitability of asthma apps for use in routine care. The findings underline the need for coordinated quality assurance processes that can adapt to changing clinical and information governance-related risks, ensure compliance with the evidence base and reflect local variations in clinical practice. It is unclear if substantial clinical benefits can be realized from a landscape dominated by low quality generic information apps and tools that do not adhere to accepted medical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0303-x) contains supplementary material, which is available to authorized users.

Audience, Content, Media: A Literature Review about Factors to Consider When Designing Technology Based Asthma Education Programs for Children

“…In fact, a 2012 report stated that, "half of smartphone owners use their devices to get health information and one-fifth of smartphone owners have health apps" [67]. For example, there are approximately 147 asthma applications (apps) available [68]. Of these, seven are designed for children [68].…”

“…For example, there are approximately 147 asthma applications (apps) available [68]. Of these, seven are designed for children [68]. These asthma apps are one way that researchers can begin educating children about their chronic illness and the behavioral and social management skills necessary to living with asthma.…”

“…Due to children's proclivity for electronic media, many studies focus on children's asthma management through computer-based educational methods [13][14][15][19][20][21][22]25,27]. However, relatively few researchers incorporate asthma education into mobile forms and no apps focus on preliterate children [68].…”

“…Regardless of the targeted age group, very few of the apps were working tools or based on accurate asthma information [84]. Huckvale et al 's 2015 reevaluation of the Apple iOS and Android app stores revealed similar results [68].…”

“…Despite an increase in available asthma apps (n=147), there was not a significant increase in apps for children [68]. Of the few newly released children's apps, most targeted caregivers [68].…”