Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.
Mount Sinai School of Medicine, Mount Sinai Hospital, New York, NY.
J Allergy Clin Immunol Pract. 2021 Jun;9(6):2336-2341. doi: 10.1016/j.jaip.2021.01.027. Epub 2021 Feb 4.
Technology-based interventions (TBIs) can improve asthma management by facilitating patient education, symptom monitoring, environmental trigger control, comorbid condition management, and medication adherence. Collecting patient-reported outcomes (PROs) can identify effective interventions and ensure patient-centered care, but it is unclear which TBIs have been formally evaluated using PROs.
We aim to: (1) identify the TBIs that have been evaluated in clinical trials using PROs; (2) identify the most commonly used PROs in these trials; and (3) determine the impact of TBIs on PROs in the management of chronic asthma.
We searched the PubMed and Clinicaltrials.gov databases for studies published in English between January 2000 and February 2020 using the following search criteria: "asthma," "IT-based interventions," "information technology," "technology," "dyspnea," "patient reported outcomes," "PROs," "telehealth," "telemedicine," and "mobile devices." Two independent reviewers screened the studies and determined study inclusion. Studies were examined for the types of interventions used, the types of PROs collected, and outcomes.
The final analysis included 14 clinical trials with either 1, 2, or 3 arms. Five different types of TBIs were identified, most commonly involving multimedia education. Four different categories of PROs were identified, most commonly involving treatment self-efficacy. Positive outcomes in at least 1 PRO domain were reported in 12 of 14 studies. Pooled meta-analysis was not possible due to the heterogeneity of PRO instruments across studies.
TBIs improve PROs overall in patients with asthma. Future trials investigating TBIs should include standardized PROs as endpoints to better clarify this relationship.
基于技术的干预措施（TBIs）可以通过促进患者教育、症状监测、环境触发因素控制、合并症管理和药物依从性来改善哮喘管理。收集患者报告的结果（PROs）可以确定有效的干预措施并确保以患者为中心的护理，但尚不清楚哪些 TBI 已经使用 PROs 进行了正式评估。
我们旨在：（1）确定使用 PROs 在临床试验中评估过的 TBI；（2）确定这些试验中最常用的 PRO；（3）确定 TBI 对慢性哮喘管理中 PRO 的影响。
我们使用以下搜索标准在 PubMed 和 Clinicaltrials.gov 数据库中搜索 2000 年 1 月至 2020 年 2 月期间以英文发表的研究：“哮喘”，“基于 IT 的干预措施”，“信息技术”，“技术”，“呼吸困难”，“患者报告的结果”，“PRO”，“远程保健”，“远程医疗”和“移动设备”。两名独立的审查员筛选了研究并确定了研究的纳入。研究检查了所使用的干预类型，收集的 PRO 类型以及结果。
最终分析包括 14 项具有 1、2 或 3 个臂的临床试验。确定了五种不同类型的 TBI，最常见的是涉及多媒体教育。确定了四种不同类别的 PRO，最常见的是涉及治疗自我效能。在 14 项研究中的 12 项研究中，至少在 1 个 PRO 领域报告了积极的结果。由于研究中 PRO 仪器的异质性，无法进行汇总荟萃分析。
总体而言，TBI 可改善哮喘患者的 PRO。未来研究 TBI 的试验应将标准化的 PRO 作为终点纳入其中，以更好地阐明这种关系。
