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Boonrit N, Klaidokchan N, Niyomdecha A, Noppamas J, Suknuntha K, Prasertsan P, Thaworncheep S, Ruanglertboon W. Development and Evaluation of a Prototype Mobile Application for Intravenous Drug Dose Calculation in Overweight and Obese Thai Children: Precision Dosing in Practice. Hosp Pharm 2024; 59:453-459. [PMID: 38919757 PMCID: PMC11195842 DOI: 10.1177/00185787241229141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Background: Medication dosing in overweight and obese children often involves complex weight-based calculations, leading to higher dosing errors, particularly with intravenous drugs. Currently, tools to aid in dosage calculations are lacking for these patients, especially in Thai population. Objective: This study aimed to develop a mobile application with the intent of utilizing it as a tool to enhance the efficiency and accuracy of dosing calculations required for obese and overweight Thai children. Methods: The performance of the application was assessed in 3 key aspects using a sample of 30 healthcare professionals. These key aspects included: 1) the accuracy of dosage calculations, assessed through pre- and posttests comparing manual calculations to app-based calculations using a 10-item questionnaire, 2) the time taken for calculations before and after app usage, 3) user satisfaction, which was measured through a questionnaire. Results: The integration of applications into the calculation demonstrated a significant improvement when compared to the manual calculation in both accuracy (6.10 vs 9.33 out of 10, P < .001) and efficiency (10.40 vs 8.53 minutes per 10 questions, P = .008). Also, the application elicited high levels of satisfaction among users, as reflected by an overall mean satisfaction score of 4.57 on a 5-point scale. Conclusion: The integration of this application to assist in dosage calculations for overweight and obese pediatric Thai patients has yielded favorable outcomes concerning accuracy, efficiency, and user satisfaction. Further development should be pursued within a larger cohort, with an emphasis on real-world implementation in clinical settings.
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Affiliation(s)
| | | | | | | | - Krit Suknuntha
- Prince of Songkla University, Hatyai, Songkhla, Thailand
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Mohamed BME, Laz N, Saeed H, Abdelrahim MEA, Rabea H. Efficacy-based comparison between adults and children regarding using advanced counseling for asthma. J Asthma 2024:1-7. [PMID: 38742886 DOI: 10.1080/02770903.2024.2356004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/12/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Asthma advanced counseling using smartphone applications has recently become one of the most effective and commonly used methods among adults and children with asthma. OBJECTIVES We aimed to compare the advanced counseling effectiveness between adults and children with asthma. METHODS A cohort prospective parallel study was performed on a group of adults and children nonsmoking patients with asthma, using a pressurized metered dose inhaler (pMDI). The patients were divided into two groups namely adults with asthma with ages ranging from 19 to 60 years and Children with asthma with ages ranging from 11 to 18 years, the two groups received a 2-month course of advanced counseling using "Asthma software" and "Asthma Dodge" smartphone applications, during which the two groups were monitored using the forced expiratory volume in the first second to the forced vital capacity (FEV1/FVC) ratio and asthma control test (ACT). The study has obtained ethical approval with the serial number REC-H-PhBSU-23002, adhering to the principles outlined in The Declaration of Helsinki, from the Ethical Approval Committee of Beni-Suef University Faculty of Pharmacy. RESULTS With a total of 60 patients with asthma (N = 60), 31 adults (N = 31), and 29 children (N = 29), We found that starting from the first-month visit of counseling the children group showed superiority over the adult group in terms of the pulmonary function improvement p = .006. Also, regarding ACT scores the children group showed a superiority over the adult group this significance started from the first-month visit and continued to the second-month visit with p values = .032 and .011, respectively. CONCLUSION The advanced counseling achieved better asthma control and pulmonary function improvement in children and adults; however, the improvement was much better in children with asthma than adults with asthma.
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Affiliation(s)
- Basma M E Mohamed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Nabila Laz
- Department of Chest, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Haitham Saeed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed E A Abdelrahim
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Hoda Rabea
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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Karakul A, Düzkaya DS, Bozkul G, Çapanoğlu M. The effect of mobile game training designed for asthmatic children on asthma management and quality of life. J Pediatr Nurs 2024; 76:e149-e158. [PMID: 38462418 DOI: 10.1016/j.pedn.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/02/2024] [Accepted: 02/26/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE This study aimed to examine the effect of mobile game training designed for children with asthma on inhaler use skills, asthma symptoms and treatment needs, and quality of life. DESIGN AND METHODS This randomized controlled study was conducted between April and October 2023 at "Pediatric Asthma and Allergy Clinic" in Turkey. The sample of the study consists of a total of 74 children diagnosed with asthma, including the Mobile game (n: 37) and the Control group (n: 37). In the study, a mobile game was developed for children with asthma between the ages of 8-12. In collecting research data; Child and Parent Information Form, Inhaler Use Skill Evaluation Form, Asthma Symptom and Treatment Need Scoring (Asthma Symptom Score [ASS], Rhinitis Symptom Score [RSS] and Total Symptom Score [TSS]), DISABKIDS Asthma Scale were used. RESULTS There was no significant difference between the groups in terms of the demographic status of the children (p > 0.05). It was determined that the average inhaler use skill score and DISABKIDS asthma scale Child/Parent score average of the children in the mobile game group were higher than the control group (p < 0.05). When the children's final follow-up ASS, RSS and TSS total scores were examined; It was determined that there was a statistically significant difference between the children in the mobile game and control groups (p < 0.05). CONCLUSIONS As a result of this study, it was determined that mobile game training designed for children is an effective method in increasing children's ability to use inhaler medications, reducing asthma symptoms and treatment needs, and improving quality of life. PRACTICE IMPLICATION Nurses can improve children's quality of life by using mobile game training programs that attract children's attention.
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Affiliation(s)
- Atiye Karakul
- Tarsus University, Faculty of Health Sciences, Department of Nursing, Turkey.
| | | | - Gamze Bozkul
- Tarsus University, Faculty of Health Sciences, Department of Nursing, Turkey
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Fadaizadeh L, Velayati F, Sanaat M. Telemonitoring in patients with asthma: a systematic review. J Asthma 2024; 61:92-104. [PMID: 37668320 DOI: 10.1080/02770903.2023.2255267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/20/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Monitoring and managing asthma using technology can help increase patient adherence and achieve better asthma control. This study aimed to evaluate the effectiveness of telemonitoring using smartphones and telephone communication compared to usual outpatient clinical evaluation in patients with asthma. DATA SOURCES This systematic review was conducted in 2023. Databases PubMed, Scopus, Web of Science, and the Google Scholar search engine, were searched from 2013 to 2022. DATA SELECTION The selected studies were randomized clinical trials that used telemonitoring in patients with asthma. The quality of the studies was evaluated using the JADAD scale. Data were collected using a data extraction form, and the findings were synthesized narratively. This systematic review was conducted following the PRISMA checklist. RESULTS Initially, 4,147 articles were found, of which 14 were included in the study. The results showed that in some cases, telemonitoring using smartphones and telephone communication in patients with asthma is effective, while in other studies, its effectiveness was not observed. CONCLUSIONS Telemonitoring using smartphones and telephone communication in patients with asthma can be considered an appropriate strategy to reduce the use of healthcare resources and improve quality of life. However, further studies are recommended to investigate the effectiveness of each of these technologies and their specific outcomes.
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Affiliation(s)
- Lida Fadaizadeh
- Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnia Velayati
- Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Sanaat
- Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kaplan C, Kranidis A, Saint-Fleur AL, Christophides A, Kier C. Bridging the Gap from Acute to Chronic Care: Partnerships and Tools for Pediatric Asthma. Pediatr Rev 2023; 44:578-584. [PMID: 37777653 DOI: 10.1542/pir.2022-005599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Affiliation(s)
- Carl Kaplan
- Stony Brook Children's Hospital, Stony Brook, NY
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Bertholet N, Schmutz E, Studer J, Adam A, Gmel G, Cunningham JA, McNeely J, Daeppen JB. Effect of a smartphone intervention as a secondary prevention for use among university students with unhealthy alcohol use: randomised controlled trial. BMJ 2023; 382:e073713. [PMID: 37586742 PMCID: PMC10428135 DOI: 10.1136/bmj-2022-073713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE To estimate the effects of providing access to an alcohol intervention based on a smartphone. DESIGN Randomised controlled trial.. SETTING Four higher education institutions in Switzerland. PARTICIPANTS 1770 students (≥18 years) who screened positive for unhealthy alcohol use (ie, a score on the alcohol use disorders identification test-consumption (AUDIT-C) of ≥4 for men and ≥3 for women) were randomly assigned by 1:1 allocation ratio in blocks of 10. INTERVENTION Providing access to a brief, smartphone based alcohol intervention. OUTCOME MEASURES The primary outcome studied was number of standard drinks per week at six months and the secondary outcome was number of heavy drinking days (past 30 days). Additional outcomes were maximum number of drinks consumed on one occasion, alcohol related consequences, and academic performance. Follow-up assessments occurred at months three, six, and 12. Data were analysed by intention to treat and by using generalised linear mixed models with random intercepts for the recruitment site and participants nested within the recruitment site, and with intervention (v control), time (three months v six months; 12 months v six months), and baseline outcome values as fixed effects. RESULTS Between 26 April 26 2021 and 30 May 2022, 1770 participants (intervention group (n=884); control group (n=886)) were included. Mean age was 22.4 years (standard deviation 3.07); 958 (54.1%) were women; and 1169 (66.0%) were undergraduate students, 533 (30.1%) were studying for a master's degree, 43 (2.4%) were studying for a doctorate, and 25 (1.4%) were students of other higher education programme. The baseline mean number of standard drinks per week was 8.59 (standard deviation 8.18); the baseline number of heavy drinking days was 3.53 (4.02). Of 1770 participants, follow-up rates were 1706 (96.4%) at three months, 1697 (95.9%) at six months, and 1660 (93.8%) at 12 months. Of 884 students randomly assigned to the intervention group, 738 (83.5%) downloaded the smartphone application. The intervention had a significant overall effect on the number of standard drinks per week (incidence rate ratio 0.90 (95% confidence interval 0.85 to 0.96)), heavy drinking days (0.89 (0.83 to 0.96)), and the maximum number of drinks consumed on one occasion (0.96 (0.93 to 1.00), P=0.029), indicating significantly lower drinking outcomes in the intervention group than in the control group during the follow-up period. The intervention did not affect alcohol related consequences or academic performance. CONCLUSIONS Providing access to the smartphone application throughout the 12 month follow-up was effective at limiting the average drinking volume of university students who had self-reported unhealthy alcohol use at baseline. TRIAL REGISTRATION ISRCTN 10007691.
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Affiliation(s)
- Nicolas Bertholet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elodie Schmutz
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Angéline Adam
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John A Cunningham
- National Addiction Centre, King's College, London, UK
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer McNeely
- New York University Grossman School of Medicine, New York, NY, USA
| | - Jean-Bernard Daeppen
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Wittwer LH, Walters E, Jordan K. Improving Pediatric Asthma Care Through Asthma Apps: A Narrative Review. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Dauletbaev N, Oftring ZS, Akik W, Michaelis-Braun L, Korel J, Lands LC, Waldmann S, Müller BS, Dreher M, Rohde G, Vogelmeier CF, Kuhn S. A scoping review of mHealth monitoring of pediatric bronchial asthma before and during COVID-19 pandemic. Paediatr Respir Rev 2022; 43:67-77. [PMID: 35131174 PMCID: PMC8761580 DOI: 10.1016/j.prrv.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/10/2022] [Indexed: 12/02/2022]
Abstract
Mobile (m) Health technology is well-suited for Remote Patient Monitoring (RPM) in a patient's habitual environment. In recent years there have been fast-paced developments in mHealth-enabled pediatric RPM, especially during the COVID-19 pandemic, necessitating evidence synthesis. To this end, we conducted a scoping review of clinical trials that had utilized mHealth-enabled RPM of pediatric asthma. MEDLINE, Embase and Web of Science were searched from September 1, 2016 through August 31, 2021. Our scoping review identified 25 publications that utilized synchronous and asynchronous mHealth-enabled RPM in pediatric asthma, either involving mobile applications or via individual devices. The last three years has seen the development of evidence-based, multidisciplinary, and participatory mHealth interventions. The quality of the studies has been improving, such that 40% of included study reports were randomized controlled trials. In conclusion, there exists high-quality evidence on mHealth-enabled RPM in pediatric asthma, warranting future systematic reviews and/or meta-analyses of the benefits of such RPM.
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Affiliation(s)
- Nurlan Dauletbaev
- Department of Internal, Respiratory and Critical Care Medicine, Philipps University of Marburg, Marburg, Germany (Member of the German Center for Lung Research (DZL)), Germany; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; The Research Institute of McGill University Health Centre, Montreal, QC, Canada; al-Farabi Kazakh National University, Almaty, Kazakhstan.
| | - Zoe S. Oftring
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
| | - Wided Akik
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Lukas Michaelis-Braun
- Department of Internal, Respiratory and Critical Care Medicine, Philipps University of Marburg, Marburg, Germany (Member of the German Center for Lung Research (DZL)), Germany
| | - Julia Korel
- Department of Internal, Respiratory and Critical Care Medicine, Philipps University of Marburg, Marburg, Germany (Member of the German Center for Lung Research (DZL)), Germany
| | - Larry C. Lands
- Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada,The Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Susanne Waldmann
- Central Medical Library, Philipps University of Marburg, Marburg, Germany
| | - Beate S. Müller
- Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany
| | - Gernot Rohde
- Medical Clinic 1, Department of Respiratory Medicine, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Claus F. Vogelmeier
- Department of Internal, Respiratory and Critical Care Medicine, Philipps University of Marburg, Marburg, Germany (Member of the German Center for Lung Research (DZL)), Germany
| | - Sebastian Kuhn
- Department of Digital Medicine, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
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Chan A, De Simoni A, Wileman V, Holliday L, Newby CJ, Chisari C, Ali S, Zhu N, Padakanti P, Pinprachanan V, Ting V, Griffiths CJ. Digital interventions to improve adherence to maintenance medication in asthma. Cochrane Database Syst Rev 2022; 6:CD013030. [PMID: 35691614 PMCID: PMC9188849 DOI: 10.1002/14651858.cd013030.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Asthma is the most common chronic lung condition worldwide, affecting 334 million adults and children globally. Despite the availability of effective treatment, such as inhaled corticosteroids (ICS), adherence to maintenance medication remains suboptimal. Poor ICS adherence leads to increased asthma symptoms, exacerbations, hospitalisations, and healthcare utilisation. Importantly, suboptimal use of asthma medication is a key contributor to asthma deaths. The impact of digital interventions on adherence and asthma outcomes is unknown. OBJECTIVES To determine the effectiveness of digital interventions for improving adherence to maintenance treatments in asthma. SEARCH METHODS We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial registries and reference lists of primary studies. We conducted the most recent searches on 1 June 2020, with no restrictions on language of publication. A further search was run in October 2021, but studies were not fully incorporated. SELECTION CRITERIA We included randomised controlled trials (RCTs) including cluster- and quasi-randomised trials of any duration in any setting, comparing a digital adherence intervention with a non-digital adherence intervention or usual care. We included adults and children with a clinical diagnosis of asthma, receiving maintenance treatment. DATA COLLECTION AND ANALYSIS We used standard methodological procedures for data collection. We used GRADE to assess quantitative outcomes where data were available. MAIN RESULTS We included 40 parallel randomised controlled trials (RCTs) involving adults and children with asthma (n = 15,207), of which eight are ongoing studies. Of the included studies, 30 contributed data to at least one meta-analysis. The total number of participants ranged from 18 to 8517 (median 339). Intervention length ranged from two to 104 weeks. Most studies (n = 29) reported adherence to maintenance medication as their primary outcome; other outcomes such as asthma control and quality of life were also commonly reported. Studies had low or unclear risk of selection bias but high risk of performance and detection biases due to inability to blind the participants, personnel, or outcome assessors. A quarter of the studies had high risk of attrition bias and selective outcome reporting. We examined the effect of digital interventions using meta-analysis for the following outcomes: adherence (16 studies); asthma control (16 studies); asthma exacerbations (six studies); unscheduled healthcare utilisation (four studies); lung function (seven studies); and quality of life (10 studies). Pooled results showed that patients receiving digital interventions may have increased adherence (mean difference of 14.66 percentage points, 95% confidence interval (CI) 7.74 to 21.57; low-certainty evidence); this is likely to be clinically significant in those with poor baseline medication adherence. Subgroup analysis by type of intervention was significant (P = 0.001), with better adherence shown with electronic monitoring devices (EMDs) (23 percentage points over control, 95% CI 10.84 to 34.16; seven studies), and with short message services (SMS) (12 percentage points over control, 95% CI 6.22 to 18.03; four studies). No significant subgroup differences were seen for interventions having an in-person component versus fully digital interventions, adherence feedback, one or multiple digital components to the intervention, or participant age. Digital interventions were likely to improve asthma control (standardised mean difference (SMD) 0.31 higher, 95% CI 0.17 to 0.44; moderate-certainty evidence) - a small but likely clinically significant effect. They may reduce asthma exacerbations (risk ratio 0.53, 95% CI 0.32 to 0.91; low-certainty evidence). Digital interventions may result in a slight change in unscheduled healthcare utilisation, although some studies reported no or a worsened effect. School or work absence data could not be included for meta-analysis due to the heterogeneity in reporting and the low number of studies. They may result in little or no difference in lung function (forced expiratory volume in one second (FEV1)): there was an improvement of 3.58% predicted FEV1, 95% CI 1.00% to 6.17%; moderate-certainty evidence); however, this is unlikely to be clinically significant as the FEV1 change is below 12%. Digital interventions likely increase quality of life (SMD 0.26 higher, 95% CI 0.07 to 0.45; moderate-certainty evidence); however, this is a small effect that may not be clinically significant. Acceptability data showed positive attitudes towards digital interventions. There were no data on cost-effectiveness or adverse events. Our confidence in the evidence was reduced by risk of bias and inconsistency. AUTHORS' CONCLUSIONS Overall, digital interventions may result in a large increase in adherence (low-certainty evidence). There is moderate-certainty evidence that digital adherence interventions likely improve asthma control to a degree that is clinically significant, and likely increase quality of life, but there is little or no improvement in lung function. The review found low-certainty evidence that digital interventions may reduce asthma exacerbations. Subgroup analyses show that EMDs may improve adherence by 23% and SMS interventions by 12%, and interventions with an in-person element and adherence feedback may have greater benefits for asthma control and adherence, respectively. Future studies should include percentage adherence as a routine outcome measure to enable comparison between studies and meta-analysis, and use validated questionnaires to assess adherence and outcomes.
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Affiliation(s)
- Amy Chan
- Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
- Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anna De Simoni
- Wolfson Institute of Population Health, Centre for Primary Care Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Vari Wileman
- Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Lois Holliday
- Wolfson Institute of Population Health, Centre for Primary Care Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Chris J Newby
- Research Design Service, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Claudia Chisari
- Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Sana Ali
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Natalee Zhu
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | | | | | - Victoria Ting
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Chris J Griffiths
- Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Drummond D. Outils connectés pour la télésurveillance des patients asthmatiques : gadgets ou révolution? Rev Mal Respir 2022; 39:241-257. [DOI: 10.1016/j.rmr.2022.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
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Milne-Ives M, Lam C, Meinert E. Digital Technologies for Monitoring and Improving Treatment Adherence in Children and Adolescents With Asthma: Scoping Review of Randomized Controlled Trials. JMIR Pediatr Parent 2021; 4:e27999. [PMID: 34533463 PMCID: PMC8486994 DOI: 10.2196/27999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Inadequate pediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to monitor and support treatment adherence in children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research on these technologies and how they are being integrated into existing health care services and care pathways. OBJECTIVE This study aims to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma. METHODS This study was structured according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and Population, Intervention, Comparator, Outcome, and Study frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PsycINFO) were systematically searched for studies published in English from 2014 onward. Two reviewers independently screened the references and selected studies for inclusion based on the eligibility criteria. Data were systematically extracted per research question, which were synthesized in a descriptive analysis. RESULTS A wide variety of study characteristics, including the number and age of participants, study duration, and type of digital intervention, were identified. There was mixed evidence for the effectiveness of the interventions. Of the 10 studies that evaluated treatment adherence, 7 (70%) found improvements, but the evidence was inconsistent for asthma control (6/9, 67% of studies reported improvement or maintenance, but only 1 was significantly different between groups) and health outcome variables (5/9, 56% of studies found no evidence of effectiveness). The 6 studies that examined patient perceptions and assessments of acceptability and usability generally had positive findings. CONCLUSIONS A wide range of digital interventions are being developed and evaluated to support the monitoring and treatment adherence of children and adolescents with asthma. Meta-analyses are inhibited by the use of samples with a variety of overlapping age ranges; a theoretical framework for evaluating specific age groups would aid comparison between studies. Most studies found significant evidence for improved adherence to treatment or medications, but there was mixed evidence of the impact of the digital interventions on asthma control and other health outcomes. There are gaps in the literature relating to cost-effectiveness and integration with existing clinical care pathways. This study will be necessary to determine which digital interventions for children and young people with asthma are worth supporting and adopting in the clinical care pathways.
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Affiliation(s)
- Madison Milne-Ives
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Ching Lam
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Edward Meinert
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom.,Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
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Franzmair J, Diesner-Treiber SC, Voitl JJM, Voitl P. Effective German and English Language mHealth Apps for Self-management of Bronchial Asthma in Children and Adolescents: Comparison Study. JMIR Mhealth Uhealth 2021; 9:e24907. [PMID: 34009134 PMCID: PMC8173395 DOI: 10.2196/24907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/18/2021] [Accepted: 04/16/2021] [Indexed: 12/22/2022] Open
Abstract
Background Mobile health (mHealth) apps hold great potential for asthma self-management. Data on the suitability of asthma apps intended for children are insufficient, and the availability of German language apps is still inadequate compared with English language apps. Objective This study aims to identify functional asthma apps for children in German and to compare them with English language apps. In line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the Google Play Store and Apple App Store are systematically searched to preselect the most efficient apps, which are then compared according to a self-compiled criteria catalog. Methods Both app stores were screened for the term asthma. Following a PRISMA preselection process, the apps that met the inclusion criteria (ie, available free of charge, German or English language, and suitable for children) were rated by 3 independent persons following a criteria catalog consisting of 9 categories, some conceived for this purpose (availability, child-friendly, learning factor, and range of functions) and some adopted from existing validated catalogs (functionality and design, ease of use, potential for improving asthma self-management, fun factor and incentives, and information management and medical accuracy). The highest rated apps in German and English were compared. Results A total of 403 apps were identified on the Google Play Store and the Apple App Store. Finally, 24 apps that met the inclusion criteria were analyzed. In the first step of the quality assessment, only 4 available German language asthma apps were compared with 20 English language asthma apps. The 4 German language apps were then compared with the 4 highest rated English language apps. All selected apps, independent of the language, were comparable in the following categories: availability, functionality and design, ease of use, and information management and medical accuracy. The English language apps scored significantly higher in the following categories: potential for improving self-management, child-friendly, fun factor, learning factor, and range of function. English language apps (mean total points 34.164, SD 1.09) performed significantly better than German language asthma apps (mean total points 22.91, SD 2.898; P=.003). The best rated English language app was Kiss my asthma (36/42 points), whereas the best rated German language app Kata achieved only 27.33 points. Conclusions The recommended English language apps are Kiss my asthma, AsthmaXcel, AsthmaAustralia, and Ask Me, AsthMe!, whereas the only recommended German language app is Kata. The use of apps plays an increasingly important role in patients’ lives and in the medical field, making mHealth a staple in the future of asthma treatment plans. Although validated recommendations on rating mHealth apps have been published, it remains a challenging task for physicians and patients to choose a suitable app for each case, especially in non–English-speaking countries.
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Affiliation(s)
| | | | | | - Peter Voitl
- First Vienna Pediatric Medical Center, Vienna, Austria.,Sigmund Freud University, Vienna, Austria
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Mosnaim G, Safioti G, Brown R, DePietro M, Szefler SJ, Lang DM, Portnoy JM, Bukstein DA, Bacharier LB, Merchant RK. Digital Health Technology in Asthma: A Comprehensive Scoping Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2377-2398. [PMID: 33652136 DOI: 10.1016/j.jaip.2021.02.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND A variety of digital intervention approaches have been investigated for asthma therapy during the past decade, with different levels of interactivity and personalization and a range of impacts on different outcome measurements. OBJECTIVE To assess the effectiveness of digital interventions in asthma with regard to acceptability and outcomes and evaluate the potential of digital initiatives for monitoring or treating patients with asthma. METHODS We evaluated digital interventions using a scoping review methodology through a literature search and review. Of 871 articles identified, 121 were evaluated to explore intervention characteristics, the perception and acceptability of digital interventions to patients and physicians, and effects on asthma outcomes. Interventions were categorized by their level of interactivity with the patient. RESULTS Interventions featuring non-individualized content sent to patients appeared capable of promoting improved adherence to inhaled corticosteroids, but with no identified improvement in asthma burden; and data-gathering interventions appeared to have little effect on adherence or asthma burden. Evidence of improvement in both adherence and patients' impairment due to asthma were seen only with interactive interventions involving two-way responsive patient communication. Digital interventions were generally positively perceived by patients and physicians. Implementation was considered feasible, with certain preferences for design and features important to drive use. CONCLUSIONS Digital health interventions show substantial promise for asthma disease monitoring and personalization of treatment. To be successful, future interventions will need to include both inhaler device and software elements, combining accurate measurement of clinical parameters with careful consideration of ease of use, personalization, and patient engagement aspects.
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Affiliation(s)
- Giselle Mosnaim
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, North Shore University Health System, Evanston, Ill
| | | | - Randall Brown
- Teva Branded Pharmaceutical Products R&D, Inc, West Chester, Pa
| | - Michael DePietro
- Teva Branded Pharmaceutical Products R&D, Inc, West Chester, Pa.
| | - Stanley J Szefler
- The Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - David M Lang
- Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jay M Portnoy
- Pediatric Allergy and Immunology, Children's Mercy Hospital, Kansas City School of Medicine, Kansas City, Mo
| | - Don A Bukstein
- Allergy, Asthma and Sinus Center, Milwaukee, Greenfield, Wis
| | - Leonard B Bacharier
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville, Tenn
| | - Rajan K Merchant
- Woodland Clinic Medical Group, Allergy Department, Dignity Health, Woodland, Calif
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Camacho-Rivera M, Vo H, Huang X, Lau J, Lawal A, Kawaguchi A. Evaluating Asthma Mobile Apps to Improve Asthma Self-Management: User Ratings and Sentiment Analysis of Publicly Available Apps. JMIR Mhealth Uhealth 2020; 8:e15076. [PMID: 33118944 PMCID: PMC7661227 DOI: 10.2196/15076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/10/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The development and use of mobile health (mHealth) apps for asthma management have risen dramatically over the past two decades. Asthma apps vary widely in their content and features; however, prior research has rarely examined preferences of users of publicly available apps. OBJECTIVE The goals of this study were to provide a descriptive overview of asthma mobile apps that are publicly available and to assess the usability of asthma apps currently available on the market to identify content and features of apps associated with positive and negative user ratings. METHODS Reviews were collected on June 23, 2020, and included publicly posted reviews until June 21, 2020. To characterize features associated with high or low app ratings, we first dichotomized the average user rating of the asthma app into 2 categories: a high average rating and a low average rating. Asthma apps with average ratings of 4 and above were categorized as having a high average rating. Asthma apps with average ratings of less than 4 were categorized as having a low average rating. For the sentiment analysis, we modeled both 2-word (bi-gram) and 3-word (tri-gram) phrases which commonly appeared across highly rated and lowly rated apps. RESULTS Of the 10 apps that met the inclusion criteria, a total of 373 reviews were examined across all apps. Among apps reviewed, 53.4% (199/373) received high ratings (average ratings of 4 or 5) and 47.2% (176/373) received low ratings (average ratings of 3 or less). The number of ratings across all apps ranged from 188 (AsthmaMD) to 10 (My Asthma App); 30% (3/10) of apps were available on both Android and iOS. From the sentiment analysis, key features of asthma management that were common among highly rated apps included the tracking of peak flow readings (n=48), asthma symptom monitoring (n=11), and action plans (n=10). Key features related to functionality that were common among highly rated apps included ease of use (n=5). Users most commonly reported loss of data (n=14) and crashing of app (n=12) as functionality issues among poorly rated asthma apps. CONCLUSIONS Our study results demonstrate that asthma app quality, maintenance, and updates vary widely across apps and platforms. These findings may call into question the long-term engagement with asthma apps, a crucial factor for determining their potential to improve asthma self-management and asthma clinical outcomes.
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Affiliation(s)
- Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Huy Vo
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
| | - Xueqi Huang
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
| | - Julia Lau
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
| | - Adeola Lawal
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY, United States
| | - Akira Kawaguchi
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
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