myAirCoach的有效性：一种用于哮喘的移动健康自我管理系统

Effectiveness of myAirCoach: A mHealth Self-Management System in Asthma.

作者信息

Khusial Rishi J, Honkoop Persijn J, Usmani Omar, Soares Marcia, Simpson Andrew, Biddiscombe Martyn, Meah Sally, Bonini Matteo, Lalas Antonios, Polychronidou Eleftheria, Koopmans Julia G, Moustakas Konstantinos, Snoeck-Stroband Jiska B, Ortmann Steffen, Votis Konstantinos, Tzovaras Dimitrios, Chung Kian Fan, Fowler Stephen, Sont Jacob K

机构信息

Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.

出版信息

J Allergy Clin Immunol Pract. 2020 Jun;8(6):1972-1979.e8. doi: 10.1016/j.jaip.2020.02.018. Epub 2020 Mar 3.

DOI:10.1016/j.jaip.2020.02.018

PMID:32142961

Abstract

BACKGROUND

Self-management programs have beneficial effects on asthma control, but their implementation in clinical practice is poor. Mobile health (mHealth) could play an important role in enhancing self-management.

OBJECTIVE

To assess the clinical effectiveness and technology acceptance of myAirCoach-supported self-management on top of usual care in patients with asthma using inhalation medication.

METHODS

Patients were recruited in 2 separate studies. The myAirCoach system consisted of an inhaler adapter, an indoor air-quality monitor, a physical activity tracker, a portable spirometer, a fraction exhaled nitric oxide device, and an app. The primary outcome was asthma control; secondary outcomes were exacerbations, quality of life, and technology acceptance. In study 1, 30 participants were randomized to either usual care or myAirCoach support for 3 to 6 months; in study 2, 12 participants were provided with the myAirCoach system in a 3-month before-after study.

RESULTS

In study 1, asthma control improved in the intervention group compared with controls (Asthma Control Questionnaire difference, 0.70; P = .006). A total of 6 exacerbations occurred in the intervention group compared with 12 in the control group (hazard ratio, 0.31; P = .06). Asthma-related quality of life improved (mini Asthma-related Quality of Life Questionnaire difference, 0.53; P = .04), but forced expiratory volume in 1 second was unchanged. In study 2, asthma control improved by 0.86 compared with baseline (P = .007) and quality of life by 0.16 (P = .64). Participants reported positive attitudes toward the system.

DISCUSSION

Using the myAirCoach support system improves asthma control and quality of life, with a reduction in severe asthma exacerbations. Well-validated mHealth technologies should therefore be further studied.

摘要

背景

自我管理项目对哮喘控制有有益影响，但在临床实践中的实施情况不佳。移动健康（mHealth）在加强自我管理方面可发挥重要作用。

目的

评估在使用吸入药物治疗的哮喘患者中，myAirCoach支持的自我管理在常规护理基础上的临床效果和技术接受度。

方法

在两项独立研究中招募患者。myAirCoach系统由一个吸入器适配器、一个室内空气质量监测仪、一个身体活动追踪器、一个便携式肺功能仪、一个呼出一氧化氮分数测定仪和一个应用程序组成。主要结局是哮喘控制；次要结局是病情加重、生活质量和技术接受度。在研究1中，30名参与者被随机分为接受常规护理或myAirCoach支持，为期3至6个月；在研究2中，12名参与者在一项为期3个月的前后对照研究中使用myAirCoach系统。

结果

在研究1中，与对照组相比，干预组的哮喘控制情况有所改善（哮喘控制问卷差异为0.70；P = 0.006）。干预组共发生6次病情加重，而对照组为12次（风险比为0.31；P = 0.06）。哮喘相关生活质量得到改善（哮喘相关生活质量小问卷差异为0.53；P = 0.04），但一秒用力呼气量未改变。在研究2中，与基线相比，哮喘控制改善了0.86（P = 0.007），生活质量改善了0.16（P = 0.64）。参与者对该系统表示出积极态度。