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

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, Kostas; Snoeck-Stroband, Jiska B.; Ortmann, Steffen; Votis, Konstantinos; Tzovaras, Dimitrios; Chung, Kian Fan; Fowler, Stephen; Sont, Jacob K.

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.

Citation

Khusial, R. J., Honkoop, P. J., Usmani, O., Soares, M., Simpson, A., Biddiscombe, M., Meah, S., Bonini, M., Lalas, A., Polychronidou, E., Koopmans, J. G., Moustakas, K., Snoeck-Stroband, J. B., Ortmann, S., Votis, K., Tzovaras, D., Chung, K. F., Fowler, S., & Sont, J. K. (2020). Effectiveness of myAirCoach: A mHealth Self-Management System in Asthma. The journal of allergy and clinical immunology. In practice, 8(6), 1972-1979.e8. https://doi.org/10.1016/j.jaip.2020.02.018

• Journal Article Type: Article
• Acceptance Date: Feb 10, 2020
• Online Publication Date: Mar 3, 2020
• Publication Date: 2020-06
• Deposit Date: Mar 4, 2020
• Publicly Available Date: Mar 16, 2020
• Journal: Journal of Allergy and Clinical Immunology: In Practice
• Print ISSN: 2213-2198
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 6
• Pages: 1972-1979.e8
• DOI: https://doi.org/10.1016/j.jaip.2020.02.018
• Keywords: Immunology and Allergy; asthma; mHealth; app; eHealth; telemedicine; self-management; quality of life; personalized care
• Public URL: https://hull-repository.worktribe.com/output/3456596
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2213219820301781?via%3Dihub