Unbound MEDLINE

Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial.

Abstract

OBJECTIVE
To determine whether mobile phone based monitoring improves asthma control compared with standard paper based monitoring strategies.
DESIGN
Multicentre randomised controlled trial with cost effectiveness analysis.
SETTING
UK primary care.
PARTICIPANTS
288 adolescents and adults with poorly controlled asthma (asthma control questionnaire (ACQ) score ≥ 1.5) from 32 practices.
INTERVENTION
Participants were centrally randomised to twice daily recording and mobile phone based transmission of symptoms, drug use, and peak flow with immediate feedback prompting action according to an agreed plan or paper based monitoring.
MAIN OUTCOME MEASURES
Changes in scores on asthma control questionnaire and self efficacy (knowledge, attitude, and self efficacy asthma questionnaire (KASE-AQ)) at six months after randomisation. Assessment of outcomes was blinded. Analysis was on an intention to treat basis.
RESULTS
There was no significant difference in the change in asthma control or self efficacy between the two groups (ACQ: mean change 0.75 in mobile group v 0.73 in paper group, mean difference in change -0.02 (95% confidence interval -0.23 to 0.19); KASE-AQ score: mean change -4.4 v -2.4, mean difference 2.0 (-0.3 to 4.2)). The numbers of patients who had acute exacerbations, steroid courses, and unscheduled consultations were similar in both groups, with similar healthcare costs. Overall, the mobile phone service was more expensive because of the expenses of telemonitoring.
CONCLUSIONS
Mobile technology does not improve asthma control or increase self efficacy compared with paper based monitoring when both groups received clinical care to guidelines standards. The mobile technology was not cost effective.
TRIAL REGISTRATION
Clinical Trials NCT00512837.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors

    Ryan D, Price D, Musgrave SD, Malhotra S, Lee AJ, Ayansina D, Sheikh A, Tarassenko L, Pagliari C, Pinnock H

    Source

    BMJ (Clinical research ed.) 344: 2012 pg e1756

    MeSH

    Adolescent
    Adult
    Asthma
    Attitude to Health
    Cellular Phone
    Cost-Benefit Analysis
    Directive Counseling
    Female
    Hotlines
    Humans
    Male
    Middle Aged
    Monitoring, Physiologic
    Outcome Assessment (Health Care)
    Patient Participation
    Primary Health Care
    Quality of Life
    Questionnaires
    Remote Consultation
    Self Care
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22446569