Poureslami Iraj, Shum Jessica, Lester Richard T, Tavakoli Hamid, Dorscheid Delbert R, FitzGerald J Mark
a Division of Respiratory Medicine, Department of Medicine , Institute for Heart and Lung Health, The University of British Columbia , Vancouver , Canada.
b Centre for Clinical Epidemiology and Evaluation , Vancouver Coastal Health Research Institute, The University of British Columbia , Vancouver , Canada.
J Asthma. 2018 Oct 16:1-13. doi: 10.1080/02770903.2018.1500583.
We compared electronic asthma action plans (eAAP) supported by automated text messaging service (SMS) with written asthma action plans (AAP) on assessing acceptability and asthma control improvement. We hypothesized that the patients in eAAP group would have more improvements in their quality of life, asthma control and decreased asthma exacerbations.
Patients with physician-diagnosed asthma having at least one asthma exacerbation in the previous 12 months were recruited. Participants received individualized action plans and were randomly assigned into either the intervention (eAAP) or control (AAP) group. Intervention participants received weekly SMS, triggering assessment of asthma control and viewing their eAAP. We assessed applicability of Telehealth platform on asthma exacerbations, asthma control, and quality of life over a 12-month period.
106 patients were enrolled (eAAP = 52, AAP = 54). The cumulative response rate to all weekly SMS check-ins was 68.4%. Overall, 28% of patients checked into their eAAP during the intervention period. There were fewer exacerbations in the eAAP group (18%) compared to the AAP group (RR = 0.82 [95%CI 0.49, 1.36]), (P = 0.44). The mean scores for asthma control and quality of life were higher in the eAAP group compared to the AAP group by 4% (RR = 1.04 [95%CI 0.83, 1.30]), (P = 0.73) and 5.5% (RR = 1.06 [95%CI 0.87, 1.28]), (P = 0.59), respectively, but were not statistically significant.
We demonstrated that the eAAP presented improved asthma control outcomes, but as expected the sample size was inadequate to show a significant difference, but based on this pilot study we plan a larger appropriately powered randomized controlled trial (RCT).
我们比较了由自动短信服务（SMS）支持的电子哮喘行动计划（eAAP）与书面哮喘行动计划（AAP）在评估可接受性和改善哮喘控制方面的效果。我们假设eAAP组的患者在生活质量、哮喘控制方面会有更大改善，且哮喘急性发作次数会减少。
招募过去12个月内有至少一次哮喘急性发作且经医生诊断为哮喘的患者。参与者接受个性化行动计划，并被随机分为干预组（eAAP）或对照组（AAP）。干预组参与者每周收到短信，触发哮喘控制评估并查看其eAAP。我们在12个月期间评估远程医疗平台在哮喘急性发作、哮喘控制和生活质量方面的适用性。
共纳入106例患者（eAAP组 = 52例，AAP组 = 54例）。所有每周短信检查的累积回复率为68.4%。总体而言，28%的患者在干预期间查看了他们的eAAP。与AAP组相比，eAAP组的急性发作次数更少（18%）（相对危险度 = 0.82 [95%置信区间0.49, 1.36]），（P = 0.44）。与AAP组相比，eAAP组哮喘控制和生活质量的平均得分分别高出4%（相对危险度 = 1.04 [95%置信区间0.83, 1.30]），（P = 0.73）和5.5%（相对危险度 = 1.06 [95%置信区间0.87, 1.28]），（P = 0.59），但差异无统计学意义。
我们证明eAAP改善了哮喘控制结果，但正如预期的那样，样本量不足以显示出显著差异，但基于这项初步研究，我们计划开展一项规模更大、有足够效力的随机对照试验（RCT）。
