Division of Allergy and Immunology, Nationwide Children's Hospital, Columbus, Ohio.
Allergy Partners, Indianapolis, Indiana.
Ann Allergy Asthma Immunol. 2018 Apr;120(4):395-400.e1. doi: 10.1016/j.anai.2018.02.006. Epub 2018 Feb 13.
Mobile health applications for asthma are increasingly being developed. However, there are no published randomized controlled trials evaluating efficacy in decreasing exacerbations.
To evaluate the impact of a mobile asthma application for asthma-related urgent health care usage.
We conducted a 6-month prospective randomized controlled trial for patients (6 months-21 years old) with persistent asthma presenting with an asthma exacerbation to the emergency department of a pediatric academic medical center. Participants were randomized to AsthmaCare (application providing medication and trigger reminders and treatment plan) or the control (online asthma information). Primary outcome measures were comparison of emergency department and urgent care visits and hospitalizations 6 months before and after randomization.
AsthmaCare participants (n = 98) were slightly older (7.84 vs 6.24 years; P = .02) than controls (n = 95) but similar for sex (55% vs 62% boys), race (83% vs 77% African American), and insurer (89% vs 98% Medicaid). The 2 groups were similar in having more than 2 comorbidities (34% vs 32%) and receiving National Heart, Lung, and Blood Institute step 3 treatment or higher (69% vs 57%). There was no significant decrease in emergency department or urgent care visits or hospitalizations between the intervention and control groups. AsthmaCare participants were more likely to report improvement in asthma management 6 months after study enrollment (79% vs 64%; P = .06).
This randomized controlled trial did not demonstrate a significant decrease in asthma-related emergency department visits or hospitalizations among children who used a mobile health application.
ClinicalTrials.gov, Identifier NCT02333630.
越来越多的移动医疗应用程序被开发用于治疗哮喘。然而,目前尚无已发表的随机对照试验评估其在减少哮喘恶化方面的疗效。
评估一款用于治疗哮喘的移动应用程序对与哮喘相关的紧急医疗保健使用的影响。
我们进行了一项为期 6 个月的前瞻性随机对照试验,纳入了因哮喘发作而前往儿科学术医疗中心急诊的持续性哮喘患者(6 个月至 21 岁)。参与者被随机分为 AsthmaCare 组(应用程序提供药物和触发提醒以及治疗计划)或对照组(在线哮喘信息)。主要结局指标为随机分组前 6 个月和后 6 个月急诊就诊和就诊的比较。
AsthmaCare 组(n=98)参与者比对照组(n=95)年龄稍大(7.84 岁比 6.24 岁;P=0.02),但两组的性别(55%比 62%为男孩)、种族(83%比 77%为非裔美国人)和保险类型(89%比 98%为医疗补助)相似。两组在患有 2 种以上合并症(34%比 32%)和接受美国国立心肺血液研究所第 3 步治疗或更高治疗(69%比 57%)方面也相似。干预组和对照组之间在急诊就诊或就诊或住院治疗方面没有显著减少。在研究入组后 6 个月,AsthmaCare 组参与者更有可能报告哮喘管理得到改善(79%比 64%;P=0.06)。
这项随机对照试验并未显示使用移动健康应用程序的儿童哮喘相关急诊就诊或住院治疗次数显著减少。
ClinicalTrials.gov,标识符 NCT02333630。