移动医疗应用程序在日本成年哮喘患者中的应用：临床观察研究。
Mobile Health App for Japanese Adult Patients With Asthma: Clinical Observational Study.
机构信息
Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.
Research Institute for Diseases of Old Ages, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.
出版信息
J Med Internet Res. 2020 Aug 14;22(8):e19006. doi: 10.2196/19006.
BACKGROUND
Inappropriate asthma control reduces quality of life and causes increased exacerbations. Mobile health (mHealth) employs information and communication technology for surveying health-related issues.
OBJECTIVE
This noninterventional, observational study assessed current real-world asthma control levels among Japanese patients with asthma and cough variant asthma (CVA) using the Zensoku-Log app.
METHODS
We developed the app using the ResearchKit platform and conducted a mobile-based, self-reporting, observational survey among patients with asthma and CVA. The app was downloaded 7855 times between February 2016 and February 2018, and enabled collection of data on symptoms, comorbidities, quality of life, medications, asthma control, and adherence.
RESULTS
Of the 1744 eligible participants (median age 33 years; range 20-74 years; male-to-female ratio 38.7:61.3), 50.97% (889/1744) reported unscheduled visits, 62.84% (1096/1744) reported regularly scheduled visits, 23.14% (402/1737) smoked, and 40.75% (705/1730) had pets. In addition, 91.89% (1598/1739) of participants had atopic predisposition, including allergic rhinitis and atopic dermatitis. Daily inhaled corticosteroid and oral corticosteroid treatment had been prescribed for 89.45% (1552/1735) and 22.07% (383/1735) of participants, respectively. Although an asthma control questionnaire demonstrated poor asthma control in 58.48% (1010/1727), a leukotriene receptor antagonist, theophylline, and a long-acting muscarinic antagonist had been prescribed for only 30.66% (532/1735), 15.91% (276/1735), and 4.38% (76/1735), respectively. The Adherence Starts with Knowledge 12 total score was 29. In the 421 participants who repeated the questionnaire, asthma control increased significantly between the initial and last rounds (P=.002).
CONCLUSIONS
Users of this mHealth app in Japan had poorly controlled asthma and may need more treatment for asthma and their comorbidities. Repeated app users demonstrated improved asthma control.
TRIAL REGISTRATION
UMIN Clinical Trial Registry UMIN000021043; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023913.
背景
哮喘控制不佳会降低生活质量并导致加重。移动医疗（mHealth）利用信息和通信技术来调查与健康相关的问题。
目的
本非干预性、观察性研究使用 Zensoku-Log 应用程序评估了日本哮喘和咳嗽变异性哮喘（CVA）患者的当前真实世界哮喘控制水平。
方法
我们使用 ResearchKit 平台开发了该应用程序，并对哮喘和 CVA 患者进行了基于移动的自我报告观察性调查。该应用程序于 2016 年 2 月至 2018 年 2 月期间被下载了 7855 次，能够收集症状、合并症、生活质量、药物、哮喘控制和依从性的数据。
结果
在 1744 名合格参与者中（中位数年龄 33 岁；范围 20-74 岁；男女比例 38.7:61.3），50.97%（889/1744）报告了不定期就诊，62.84%（1096/1744）报告了定期就诊，23.14%（402/1737）吸烟，40.75%（705/1730）有宠物。此外，91.89%（1598/1739）的参与者有特应性倾向，包括过敏性鼻炎和特应性皮炎。89.45%（1552/1735）和 22.07%（383/1735）的参与者分别接受了每日吸入皮质类固醇和口服皮质类固醇治疗。尽管哮喘控制问卷显示哮喘控制不佳的比例为 58.48%（1010/1727），但仅有 30.66%（532/1735）、15.91%（276/1735）和 4.38%（76/1735）的参与者接受了白三烯受体拮抗剂、茶碱和长效毒蕈碱拮抗剂治疗。知识 12 总分为 29 分。在重复问卷的 421 名参与者中，哮喘控制在初始和最后一轮之间显著增加（P=.002）。
结论
使用此日本移动医疗应用程序的用户哮喘控制不佳，可能需要更多治疗哮喘及其合并症的药物。重复使用应用程序的患者哮喘控制得到改善。
试验注册
UMIN 临床试验注册 UMIN000021043；https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023913。
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