Division of Pulmonary, Allergy and Critical Care, Department of Medicine, North Shore University Health System, Evanston, Ill.
Teva Pharmaceutical Industries, Ltd, Amsterdam, The Netherlands.
J Allergy Clin Immunol Pract. 2021 Jun;9(6):2377-2398. doi: 10.1016/j.jaip.2021.02.028. Epub 2021 Feb 27.
A variety of digital intervention approaches have been investigated for asthma therapy during the past decade, with different levels of interactivity and personalization and a range of impacts on different outcome measurements.
To assess the effectiveness of digital interventions in asthma with regard to acceptability and outcomes and evaluate the potential of digital initiatives for monitoring or treating patients with asthma.
We evaluated digital interventions using a scoping review methodology through a literature search and review. Of 871 articles identified, 121 were evaluated to explore intervention characteristics, the perception and acceptability of digital interventions to patients and physicians, and effects on asthma outcomes. Interventions were categorized by their level of interactivity with the patient.
Interventions featuring non-individualized content sent to patients appeared capable of promoting improved adherence to inhaled corticosteroids, but with no identified improvement in asthma burden; and data-gathering interventions appeared to have little effect on adherence or asthma burden. Evidence of improvement in both adherence and patients' impairment due to asthma were seen only with interactive interventions involving two-way responsive patient communication. Digital interventions were generally positively perceived by patients and physicians. Implementation was considered feasible, with certain preferences for design and features important to drive use.
Digital health interventions show substantial promise for asthma disease monitoring and personalization of treatment. To be successful, future interventions will need to include both inhaler device and software elements, combining accurate measurement of clinical parameters with careful consideration of ease of use, personalization, and patient engagement aspects.
在过去十年中，已经研究了各种数字干预方法来治疗哮喘，这些方法的交互性和个性化程度不同，对不同的结果测量也有不同的影响。
评估数字干预措施在哮喘方面的有效性，包括可接受性和结果，并评估数字计划在监测或治疗哮喘患者方面的潜力。
我们通过文献检索和综述，使用范围综述方法评估数字干预措施。在确定的 871 篇文章中，评估了 121 篇文章，以探讨干预措施的特征、患者和医生对数字干预措施的感知和可接受性，以及对哮喘结果的影响。干预措施按与患者的交互水平进行分类。
向患者发送非个性化内容的干预措施似乎能够促进吸入皮质激素的依从性改善，但哮喘负担没有明显改善；数据收集干预措施对依从性或哮喘负担似乎没有影响。只有涉及双向响应式患者沟通的交互式干预措施，才能看到对依从性和患者因哮喘而受损的改善。患者和医生普遍对数字干预措施持积极态度。实施被认为是可行的，对设计和功能有一定的偏好，这些偏好对于推动使用很重要。
数字健康干预措施为哮喘疾病监测和治疗个性化提供了很大的希望。为了取得成功，未来的干预措施将需要同时包括吸入器设备和软件元素，将临床参数的精确测量与易用性、个性化和患者参与方面的仔细考虑结合起来。
