Beydon N, Delclaux C
Unité fonctionnelle de physiologie, explorations fonctionnelles respiratoires et du sommeil, hôpital Armand-Trousseau, Assistance publique-Hôpitaux de Paris, 26, avenue du Docteur-Arnold-Netter, 75571 Paris cedex 12, France; Inserm U 938, centre de recherche Saint-Antoine, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Service de physiologie, explorations fonctionnelles pédiatriques, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France.
Rev Mal Respir. 2017 Nov;34(9):1026-1033. doi: 10.1016/j.rmr.2016.10.881. Epub 2017 Sep 18.
A written action plan (WAP) reduces emergency visits for asthma exacerbations. However, a WAP is underused and often focused on asthma control. The innovation is an AppWeb that includes an expert software aimed at diagnosing the level of severity of asthma exacerbations and delivering a personalized digital action plan (DAP) when patients are in urgent need of medical advice. Symptoms describing the level of severity of asthma exacerbations and the consequent treatments have been established by working groups of the French Respiratory Societies (SPLF and SP2A for adults and children, respectively). The main objective of the study is to evaluate the effect of the DAP on the frequency of urgent medical attendance. Secondary objectives are to evaluate adherence to the DAP compared to a WAP and the qualitative satisfaction of patients using the DAP.
A randomized, prospective, comparative, multicenter study on two parallel groups, conducted in private practice and in hospitals. In both arms, asthmatic patients (240 children aged 6 to 12 years and 270 adults aged 18 to 50 years) with severe asthma exacerbation(s) during the previous year and an Internet connection via a smartphone or a tablet computer, will have at their disposal a WAP and one arm will have, in addition, the DAP. Included patients will be followed up every three months for one year.
A decrease in the number of urgent medical attendances and better adherence in the WAP+DAP group compared to the WAP group.
书面行动计划（WAP）可减少哮喘急性发作的急诊就诊次数。然而，WAP的使用不足，且通常侧重于哮喘控制。创新之处在于一个应用程序网络（AppWeb），其中包括一款专家软件，旨在诊断哮喘急性发作的严重程度，并在患者急需医疗建议时提供个性化数字行动计划（DAP）。描述哮喘急性发作严重程度及相应治疗方法的症状已由法国呼吸学会的工作组（分别针对成人和儿童的SPLF和SP2A）确定。该研究的主要目的是评估DAP对紧急就医频率的影响。次要目的是评估与WAP相比对DAP的依从性以及使用DAP的患者的定性满意度。
在私人诊所和医院对两个平行组进行随机、前瞻性、比较性多中心研究。在两组中，前一年有严重哮喘急性发作且通过智能手机或平板电脑联网的哮喘患者（240名6至12岁儿童和270名18至50岁成人）将可获得一份WAP，此外，其中一组还将获得DAP。纳入的患者将接受为期一年、每三个月一次的随访。
与WAP组相比，WAP + DAP组的紧急就医次数减少，依从性更好。
