Assessing adolescent asthma symptoms and adherence using mobile phones.
Assessing adolescent asthma symptoms and adherence using mobile phones.
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DOI：
10.2196/jmir.2413
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发表时间：
2013-07-17
影响因子：
7.4
通讯作者：
Johnson KB
中科院分区：
文献类型：
--
作者：
Mulvaney SA;Ho YX;Cala CM;Chen Q;Nian H;Patterson BL;Johnson KB
自我报告是测量药物依从性的最常见方法，但受回忆错误和反应偏差的影响，并且通常无法深入了解依从性差的原因。使用移动的电话对健康行为进行生态瞬时评估（EMA）为评估依从性和收集相关数据提供了一种有前途的替代方案，这些数据可用于临床依从性问题的解决。确定通过移动的电话使用EMA评估青少年哮喘药物依从性的可行性，并确定依从性决策的背景特征。我们采用描述性和相关性研究设计，探索使用交互式语音应答系统进行症状和依从性评估的移动的方法。从一个学术医学中心招募了12-18岁的青少年，诊断为哮喘并开具吸入剂处方。在基线时进行了一项调查，包括移动的电话使用障碍、疾病管理调查和儿童哮喘生活质量问卷。通过每天拨打移动的电话对哮喘症状和依从性进行定量和定性评估，持续1个月。在2个研究时间点进行哮喘控制试验（ACT）：基线和基线后1个月。样本包括53名青少年，主要是非裔美国人（34/53，64%）和女性（31/53，58%），收入为4万美元/年或更低（29/53，55%）。大多数青少年（37/53，70%）报告说，他们随身携带他们的手机，但只有47%（25/53）能够在学校使用他们的移动的手机。青少年回答了平均20.1（SD 8.1）的30个日常电话（67%）。应答频率在该月的最后一周下降（B=-0.29，P<.001），与EMA报告的急救吸入器依从性水平相关（r= 0.33，P=.035）。使用EMA，青少年平均每天报告0.63（SD 1.2）个哮喘症状，当他们出现症状时，平均70%的时间（SD 35%）使用急救吸入器。大约一半（26/49，53%）的不遵守情况发生在朋友在场的情况下。EMA测量的急救吸入器使用依从性与ACT测量的哮喘控制适当相关（r=-0.33，P=.034）。移动的电话为评估青少年哮喘症状和依从性提供了一种可行的方法。EMA方法与ACT一致，ACT是一种广泛建立的哮喘控制措施，其结果提供了关于依从性决策背景的有价值的见解，可用于临床解决问题或在移动的或基于Web的支持系统中反馈给青少年。
Self-report is the most common method of measuring medication adherence but is influenced by recall error and response bias, and it typically does not provide insight into the causes of poor adherence. Ecological momentary assessment (EMA) of health behaviors using mobile phones offers a promising alternative to assessing adherence and collecting related data that can be clinically useful for adherence problem solving. To determine the feasibility of using EMA via mobile phones to assess adolescent asthma medication adherence and identify contextual characteristics of adherence decision making. We utilized a descriptive and correlational study design to explore a mobile method of symptom and adherence assessment using an interactive voice response system. Adolescents aged 12-18 years with a diagnosis of asthma and prescribed inhalers were recruited from an academic medical center. A survey including barriers to mobile phone use, the Illness Management Survey, and the Pediatric Asthma Quality of Life Questionnaire were administered at baseline. Quantitative and qualitative assessment of asthma symptoms and adherence were conducted with daily calls to mobile phones for 1 month. The Asthma Control Test (ACT) was administered at 2 study time points: baseline and 1 month after baseline. The sample consisted of 53 adolescents who were primarily African American (34/53, 64%) and female (31/53, 58%) with incomes US$40K/year or lower (29/53, 55%). The majority of adolescents (37/53, 70%) reported that they carried their phones with them everywhere, but only 47% (25/53) were able to use their mobile phone at school. Adolescents responded to an average of 20.1 (SD 8.1) of the 30 daily calls received (67%). Response frequency declined during the last week of the month (b=-0.29, P<.001) and was related to EMA-reported levels of rescue inhaler adherence (r= 0.33, P=.035). Using EMA, adolescents reported an average of 0.63 (SD 1.2) asthma symptoms per day and used a rescue inhaler an average of 70% of the time (SD 35%) when they experienced symptoms. About half (26/49, 53%) of the instances of nonadherence took place in the presence of friends. The EMA-measured adherence to rescue inhaler use correlated appropriately with asthma control as measured by the ACT (r=-0.33, P=.034). Mobile phones provided a feasible method to assess asthma symptoms and adherence in adolescents. The EMA method was consistent with the ACT, a widely established measure of asthma control, and results provided valuable insights regarding the context of adherence decision making that could be used clinically for problem solving or as feedback to adolescents in a mobile or Web-based support system.
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影响因子：
7.4
作者：
Schnall R;Okoniewski A;Tiase V;Low A;Rodriguez M;Kaplan S
通讯作者：
Kaplan S
影响因子：
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作者：
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作者：
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影响因子：
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作者：
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通讯作者：
Kercsmar, Carolyn
影响因子：
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通讯作者：
Kosinski, Mark