Feasibility of a smartphone application based action plan and monitoring in asthma

Abstract

Background: Asthma patients may experience acute episodic exacerbation. The guidelines recommend that written action plan should be given to asthma patients. However, no one can predict when and where acute exacerbation will happen. As people carry smart phone almost anytime and anywhere, smartphone application could be a useful tool in asthma care. We evaluated the feasibility of the ubiquitous healthcare system of asthma care using a smartphone application (snuCare) based on the self-management guideline or action plan.

Methods: Forty-four patients including fragile asthmatics were enrolled from Seoul National University Bundang Hospital between December 2011 and February 2012. They were randomly assigned into application user (n = 22) or application nonuser group (n = 22). We evaluated user-satisfaction, and clinical parameters such as asthma control, Quality of Life Questionnaire for Adult Korean Asthmatics, and the adherence of patients.

Results: The characteristics were similar at baseline between the 2 groups except those who treated with short-term systemic steroid or increased dose of systemic steroid during previous 8 weeks (user vs. nonuser: 31.8% vs. 4.5%, p = 0.020). Total of 2,226 signals was generated during 8 weeks including 5 risky states. After eight weeks, the users answered that it was very easy to use the application, which was shown in highest scores in terms of satisfaction (mean ± standard deviation, 4.3 ± 0.56). Seventy-three percent of patients answered that the application was very useful for asthma care. User group showed improved the adherence scores (p = 0.017). One patient in application user group could avoid Emergency Department visit owing to the application while a patient in nonuser group visited Emergency Department.

Conclusion: The ubiquitous healthcare system using a smartphone application (snuCare) based on the self-management guideline or action plan could be helpful in the monitoring and the management of asthma.

Keywords: Application; Asthma; Mobile medicine; Smartphone; Telemedicine; Ubiquitous health care.

Figures

Fig. 1. (A) The questionnares on the satisfaction using the smartphone application. (B) Most of the users anwered that the smartphone application (snuCare, Division of Allergy and Clinical Immunology, Seoul National University Bundang Hospital, Seongnam, Korea) based on the self-management guideline was helpful to control asthma.

Fig. 2. Signal generated by applications; Mean number of signal per each person ± standard deviation = 101 ± 26.9.

Fig. 3. Changes of FEV1, ACT, adherence of medication and QLQAKA. (A–D) Application users; (E–H) Application nonusers. Values are presented as median (range). FEV1, forced expiratory volume in 1 second; ACT, asthma control test; QLQAKA, Quality of Life Questionnaire for Adult Korean Asthmatics; V1, 4-week study period; V2, 8-week study period. *p value, statistical method was the nonparametric test.