myAirCoach的有效性：一项关于移动健康管理系统的哮喘患者自我管理研究
2020/06/11
摘要
背景：自我管理对哮喘的控制有积极作用，但在临床实践中实施效果不佳。移动健康管理（mHealth）可以在增强自我管理方面发挥重要作用。
目的：评价myAirCoach系统在哮喘患者吸入治疗日常照护基础上自我管理的临床效果和技术接受度。
方法：将患者分为两组。myAirCoach系统包括一个吸入器适配器、一个室内空气质量监测仪、一个体力活动跟踪器、一个便携式肺活量计、一个呼出气一氧化氮装置和一个应用程序。主要结果是哮喘控制；次要结果是病情恶化、生活质量和技术接受度。在研究1中，30名受试者被随机分配到常规照护或myAirCoach组，为期3到6个月；在研究2中，12名受试者在研究前后共使用myAirCoach系统3个月。
结果：在研究1中，干预组的哮喘控制水平比对照组有所改善（哮喘控制问卷差异，0.70；P=.006）。干预组共发生6例病情加重，对照组为12例（危险比0.31，P=0.06）。哮喘相关生活质量改善（微型哮喘相关生活质量问卷差异，0.53；P=.04），但1秒用力呼气量不变。在研究2中，哮喘控制水平比基线水平提高了0.86（P=0.007），生活质量提高了0.16（P=0.64）。参与者均报告了对该系统应用的积极态度。
讨论：使用myAirCoach系统可以改善哮喘控制和生活质量，减少严重的哮喘恶化。因此，应进一步研究有效的mHealth技术。
Effectiveness of myAirCoach: A mHealth Self-Management System in Asthma
Rishi J Khusial, Persijn J Honkoop, Omar Usmani, Marcia Soares, Andrew Simpson, Martyn Biddiscombe, Sally Meah, Matteo Bonini, Antonios Lalas, Eleftheria Polychronidou, Julia G Koopmans, Konstantinos Moustakas, Jiska B Snoeck-Stroband, Steffen Ortmann, Konstantinos Votis, Dimitrios Tzovaras, Kian Fan Chung, Stephen Fowler, Jacob K Sont, myAirCoach study group
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.
背景：自我管理对哮喘的控制有积极作用，但在临床实践中实施效果不佳。移动健康管理（mHealth）可以在增强自我管理方面发挥重要作用。
目的：评价myAirCoach系统在哮喘患者吸入治疗日常照护基础上自我管理的临床效果和技术接受度。
方法：将患者分为两组。myAirCoach系统包括一个吸入器适配器、一个室内空气质量监测仪、一个体力活动跟踪器、一个便携式肺活量计、一个呼出气一氧化氮装置和一个应用程序。主要结果是哮喘控制；次要结果是病情恶化、生活质量和技术接受度。在研究1中，30名受试者被随机分配到常规照护或myAirCoach组，为期3到6个月；在研究2中，12名受试者在研究前后共使用myAirCoach系统3个月。
结果：在研究1中，干预组的哮喘控制水平比对照组有所改善（哮喘控制问卷差异，0.70；P=.006）。干预组共发生6例病情加重，对照组为12例（危险比0.31，P=0.06）。哮喘相关生活质量改善（微型哮喘相关生活质量问卷差异，0.53；P=.04），但1秒用力呼气量不变。在研究2中，哮喘控制水平比基线水平提高了0.86（P=0.007），生活质量提高了0.16（P=0.64）。参与者均报告了对该系统应用的积极态度。
讨论：使用myAirCoach系统可以改善哮喘控制和生活质量，减少严重的哮喘恶化。因此，应进一步研究有效的mHealth技术。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2020 Mar 3;S2213-2198(20)30178-1. doi: 10.1016/j.jaip.2020.02.018.)
(J Allergy Clin Immunol Pract. 2020 Mar 3;S2213-2198(20)30178-1. doi: 10.1016/j.jaip.2020.02.018.)
Effectiveness of myAirCoach: A mHealth Self-Management System in Asthma
Rishi J Khusial, Persijn J Honkoop, Omar Usmani, Marcia Soares, Andrew Simpson, Martyn Biddiscombe, Sally Meah, Matteo Bonini, Antonios Lalas, Eleftheria Polychronidou, Julia G Koopmans, Konstantinos Moustakas, Jiska B Snoeck-Stroband, Steffen Ortmann, Konstantinos Votis, Dimitrios Tzovaras, Kian Fan Chung, Stephen Fowler, Jacob K Sont, myAirCoach study group
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.
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哮喘的遗传学和基因组学指导药物靶点发现的前景
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系统评估难治性和严重哮喘独立于单克隆生物制剂，可改善预后、减轻口服皮质类固醇的负担
