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., …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