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Mobile technology interventions for Asthma self-management: systematic review and meta-analysis

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Miller, L, Schuz, B ORCID: 0000-0002-0801-498X, Walters, J and Walters, EH ORCID: 0000-0002-0993-4374 2017 , 'Mobile technology interventions for Asthma self-management: systematic review and meta-analysis' , JMIR mHealth and uHealth, vol. 5, no. 5 , pp. 1-21 , doi: 10.2196/mhealth.7168.

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Abstract

Background: Mobile technology interventions (MTI) are becoming increasingly popular in the management of chronic healthbehaviors. Most MTI allow individuals to monitor medication use, record symptoms, or store and activate disease-managementaction plans. Therefore, MTI may have the potential to improve low adherence to medication and action plans for individualswith asthma, which is associated with poor clinical outcomes.Objective: A systematic review and meta-analysis were conducted to evaluate the efficacy of MTI on clinical outcomes as wellas adherence in individuals with asthma. As the use of evidence-based behavior change techniques (BCT) has been shown toimprove intervention effects, we also conducted exploratory analyses to determine the role of BCT and engagement with MTIas moderators of MTI efficacy.Methods: We searched electronic databases for randomized controlled trials up until June 2016. Random effect models wereused to assess the effect of MTI on clinical outcomes as well as adherence to preventer medication or symptom monitoring. Mixedeffects models assessed whether the features of the MTI (ie, use of BCT) and how often a person engaged with MTI moderatedthe effects of MTI.Results: The literature search located 11 studies meeting the inclusion criteria, with 9 providing satisfactory data for meta-analysis.Compared with standard treatment, MTI had moderate to large effect sizes (Hedges g) on medication adherence and clinicaloutcomes. MTI had no additional effects on adherence or clinical outcomes when compared with paper-based monitoring. Nomoderator effects were found, and the number of studies was small. A narrative review of the two studies, which are not includedin the meta-analysis, found similar results.Conclusions: This review indicated the efficacy of MTI for self-management in individuals with asthma and also indicated thatMTI appears to be as efficacious as paper-based monitoring. This review also suggested a need for robust studies to examine theeffects of BCT use and engagement on MTI efficacy to inform the evidence base for MTI in individuals with asthma.

Item Type: Article
Authors/Creators:Miller, L and Schuz, B and Walters, J and Walters, EH
Keywords: Asthma; Mobile technology; systematic review; self-management
Journal or Publication Title: JMIR mHealth and uHealth
Publisher: J M I R Publications, Inc.
ISSN: 2291-5222
DOI / ID Number: 10.2196/mhealth.7168
Copyright Information:

Copyright 2017 Lisa Miller, Benjamin Schüz, Julia Walters, E Haydn Walters. Licensed under Creative Commons Attribution 2.0 Generic (CC BY 2.0) https://creativecommons.org/licenses/by/2.0/

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