| Mobile-based asthma action plans for adolescents |
Burbank et al. [12] |
The primary purpose of the study was to examine the feasibility and use of a mobile asthma action plan (AAP) among adolescents with persistent asthma, aiming to understand how this tool could integrate into their daily routines and impact asthma self-management. |
The study adopted a single-arm design, exploring the implementation of an asthma action plan (AAP) via a mobile app in adolescents aged 12 to 17 with persistent asthma. Participants had their personalized AAP made available on a smartphone app and were encouraged to record daily symptoms or peak flow measurements, receiving immediate feedback based on their AAP instructions. App usage, participant satisfaction, and the effects of app use on self-efficacy scores and asthma control were analyzed. |
The adolescents used the mobile AAP a mean of 4.3 days per week, and satisfaction with the tool was high. A significant improvement was observed in asthma control scores (ACT) and self-efficacy for preventing asthma attacks, particularly among participants with uncontrolled asthma at the start of the study. |
The study was limited by its short observation period (8 weeks) and single-arm design, which may restrict the generalizability of the results. Additionally, the sample of participants was relatively small, and most of the data collected were based on self-reports. |
The results suggest that mobile AAPs are a feasible methodology for communicating AAP instructions to adolescents, potentially improving asthma control and self-efficacy in asthma management. The adolescents’ acceptance and frequent use of the app indicate that mobile technologies can be a valuable tool in asthma self-management for this population, especially in rural areas and those with limited access to healthcare resources. |
The mean age was 13.5 years, with a standard deviation of 3.47. It is noteworthy that there were 20 participants at the pre-intervention stage, but 2 participants were lost by the post-intervention stage (n = 18). |
| Electronic Adherence Monitoring in a High-Utilizing Pediatric Asthma Cohort: A Feasibility Study |
Kenyon et al. [13] |
To evaluate the feasibility and acceptability of an electronic treatment adherence monitoring intervention delivered by a community health worker to high-risk children with asthma in an urban environment. |
A prospective pilot cohort study was conducted involving children with moderate to severe persistent asthma, using electronic monitoring devices attached to their inhalers. The intervention, lasting 3 (three) months, included motivational interviews conducted by a specialized community health worker and electronic monitoring of the use of controller and rescue medications. The devices recorded inhaler usage data and alerted for inappropriate medication use, allowing the community health worker to contact families as needed to support treatment adherence. |
Three distinct patterns of controller use were identified at baseline: sustained use, periodic use, and discontinued use. All participants began using the electronic devices, but there were issues with data transmission and loss of devices. Most caregivers who completed the survey considered the technology acceptable, and there was a mean improvement in ACT scores. |
The study had a small sample size and was limited to a single clinic, which may not reflect the diversity of experiences in other contexts. Additionally, there were significant challenges related to the maintenance and data transmission of the electronic monitoring devices, which affected the consistent data collection throughout the study. |
The study demonstrated that electronic adherence monitoring in a high-risk pediatric population is feasible and generally well accepted, but it faces significant challenges that need to be addressed to improve the effectiveness of these interventions in supporting children with asthma. |
The study had 14 participants, with ages ranging from 3 to 9 years and a median age of 3.5. Approximately 57 % were male and about 43 % were female. |
| Developing and evaluating ASTHMAXcel adventures: A novel gamified mobile application for pediatric patients with asthma |
Hsia et al. [14] |
To evaluate the impact of ASTHMAXcel Adventures, a gamified pediatric version based on the guidelines of the ASTHMAXcel mobile app, on asthma control, knowledge, healthcare utilization, and patient satisfaction. |
The study was a prospective single-arm study that included pediatric patients with asthma who received asthma education through the ASTHMAXcel Adventures mobile app on an iPad tablet on-site. Instruments such as the ACT, AIRS-SR, PAIS, and Customer Satisfaction Questionnaire-8 were used to assess asthma control, knowledge, patient satisfaction, and healthcare utilization. The study duration was not explicitly specified, but according to the date descriptions, it lasted approximately 14 months. |
An increase was observed in the proportion of patients with controlled asthma, improvements in asthma knowledge and quality of life, and a reduction in emergency department visits and oral prednisone use. Patient satisfaction with the app was high, with a mean score on the Customer Satisfaction Questionnaire of approximately 30 out of 32 across all visits. |
The study had a relatively small sample size and was conducted at a single center, which may limit the generalizability of the results. Additionally, the intervention was offered only in English, which may restrict its applicability to non-English-speaking populations. |
The ASTHMAXcel Adventures app proved to be an effective and well-accepted tool for improving asthma control, disease knowledge, quality of life, and reducing the use of emergency services in pediatric patients with asthma. It holds significant potential to be integrated as a supportive tool in the management of pediatric asthma. |
The study comprised 39 participants, with a mean age of 10.5 years and a standard deviation of 2.6. Approximately 51.28 % were male and about 48.72 % were female. |
| Sensor-Based Electronic Monitoring for Asthma: A Randomized Controlled Trial |
Gupta et al. [15] |
Determine the effectiveness of a clinically integrated sensor-based inhaler monitoring intervention in improving asthma symptom control and asthma-related outcomes among a diverse sample of children with moderate to severe asthma. |
Caregiver-child dyads were randomized to receive inhalation sensors that allowed for electronic monitoring of medications. Outcomes included scores on the Asthma Control Test (>19 indicated controlled asthma) and asthma-related healthcare utilization. The caregiver's quality of life and the child's adherence to ICS were also assessed. The study lasted 12 months, with evaluations at 1, 3, 6, 9, and 12 months. |
The dyads were assigned to the control or intervention arms. At the final assessment, the mean score on the Asthma Control Test increased from 19.1 (SE = 0.3) to 21.8 (SE = 0.4) in the intervention group and from 19.4 (SE = 0.3) to 19.9 (SE = 0.4) in the control group (Δ intervention-control = 2.2; SE = 0.6; P < 0.01). The adjusted rates of emergency department visits and hospitalizations in the intervention group were significantly higher (incidence rate ratio emergency department = 2.2; SE = 0.5; P < 0.01; incidence rate ratio hospital = 3.4; SE = 1.4; P < 0.01) at the final assessment compared to the control group. The caregiver's quality of life was higher in the intervention group at the end (Δ intervention-control = 0.3; SE = 0.2; P = 0.1) than in the control group. |
Some inhalers were not compatible with the sensor, requiring participants to manually enter data into the app. Only the participants in the intervention group received sensors, preventing comparisons between groups regarding adherence to ICS or use of SABA. Although the study attempted to comprehensively capture healthcare utilization, some events may not have been recorded. Generalizability is limited for non-English-speaking individuals, as they were excluded due to the lack of an app in other languages. Additionally, there were missing data due to incomplete responses or sensor failures over time. |
The results suggest that sensor-based inhaler monitoring with clinical feedback may improve asthma control and the caregiver's quality of life across diverse populations. Increased healthcare utilization was observed among participants in the intervention group compared to the control group, indicating that further refinement is needed. |
The study segmented participants into two groups, one intervention group (n = 125) and one control group (n = 127), totaling 252 participants. The mean ages of the intervention and control groups were 9.3 (SD = 3.2) and 9.2 (SD = 3.5), respectively. The distribution by biological sex was as follows: male (69.3 % vs. 63.2 %) and female (30.7 % vs. 36.8 %). |
Use of web and mobile device technologies in the management of childhood asthma: a systematic review and meta-analysis
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