Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Ann Allergy Asthma Immunol. 2017 Mar;118(3):298-303. doi: 10.1016/j.anai.2016.11.028. Epub 2017 Jan 19.
Adolescents with asthma are at risk of poor outcomes and are traditionally difficult to reach.
To examine adolescents' use of and asthma outcomes associated with smartphone- vs paper-based asthma action plans (AAPs).
We conducted a 6-month randomized clinical trial with adolescents (12-17 years old) with persistent asthma. Participants used their respective smartphone or paper AAPs for medication instructions and peak flow or asthma symptoms logging. AAP use was measured electronically for smartphone users and via mail-in diaries for the paper group. Changes in Asthma Control Test (ACT) and self-efficacy scores were examined.
Thirty-four adolescents participated in this study (median age, 15.4 years). Participants were mostly African American (62%) with state-issued insurance (71%). Adolescents in the smartphone group accessed the AAP a median of 12.17 times per week or 4.36 days per week but only recorded medications or symptoms and peak flow data in the electronic diary a median of 10 days per month during the 6-month period. Participants in the paper group recorded data a median of 23.5 days per month on their paper diaries. Overall, there were no changes in ACT and self-efficacy scores between groups. Adolescents with uncontrolled asthma (baseline ACT score ≤19) had an improvement in ACT for the smartphone group (before, 11; after, 20) ([P = .04) compared with no change in the paper group (before, 17; after, 17) (P = .64). Adolescent satisfaction with the application was high, with 100% stating they would recommend the smartphone AAP to a friend.
Adolescents were frequent and highly satisfied users of the smartphone AAP with a subset of participants with uncontrolled asthma demonstrating possible clinical benefit. Findings suggest a need for larger-scale studies to determine the effectiveness of smartphone-based AAPs among high-risk patients with asthma.
clinicaltrials.gov Identifier: NCT02091869.
哮喘青少年存在预后不良的风险，且传统上难以接触到。
研究智能手机与纸质哮喘行动计划（AAP）在青少年中的使用情况及与哮喘结局的相关性。
我们开展了一项为期 6 个月的随机临床试验，纳入了患有持续性哮喘的青少年（12-17 岁）。参与者使用各自的智能手机或纸质 AAP 来记录药物使用说明、峰流速或哮喘症状。通过电子方式和纸质日记记录智能手机用户的 AAP 使用情况。检查哮喘控制测试（ACT）和自我效能评分的变化。
本研究共纳入 34 名青少年（中位年龄 15.4 岁）。参与者主要为非裔美国人（62%），且拥有州政府颁发的保险（71%）。智能手机组的青少年每周平均访问 AAP 12.17 次或 4.36 天/周，但在 6 个月期间仅平均每月在电子日记中记录药物或症状和峰流速数据 10 天。纸质组的参与者在纸质日记中平均每月记录 23.5 天的数据。总体而言，两组间 ACT 和自我效能评分均无变化。未控制哮喘的青少年（基线 ACT 评分≤19）的智能手机组 ACT 评分有所提高（治疗前 11 分，治疗后 20 分）（P=0.04），而纸质组无变化（治疗前 17 分，治疗后 17 分）（P=0.64）。青少年对该应用程序的满意度很高，100%的参与者表示会向朋友推荐智能手机 AAP。
青少年是智能手机 AAP 的频繁且高度满意使用者，其中一部分未控制哮喘的青少年可能具有临床获益。研究结果表明，需要开展更大规模的研究来确定智能手机 AAP 在哮喘高危患者中的有效性。
clinicaltrials.gov 标识符：NCT02091869。
