Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial.
Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial.
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DOI：
10.1136/bmj.e1756
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发表时间：
2012-03-23
期刊：
影响因子：
--
通讯作者：
Pinnock H
中科院分区：
文献类型：
--
作者：
Ryan D;Price D;Musgrave SD;Malhotra S;Lee AJ;Ayansina D;Sheikh A;Tarassenko L;Pagliari C;Pinnock H
目的确定移动的电话监测是否能改善哮喘控制，与标准的纸质监测策略相比。设计多中心随机对照试验，进行成本效益分析。设置英国初级保健。参与者：来自32个诊所的288名哮喘控制不佳的青少年和成人（哮喘控制问卷（ACQ）评分≥1.5）。干预参与者被集中随机分配至每日两次记录和基于移动的电话的症状、药物使用和峰值流量的传输，并根据商定的计划或基于纸张的监测立即反馈提示行动。主要结果测量随机分组后6个月哮喘控制问卷和自我效能（哮喘知识、态度和自我效能问卷（KASE-AQ））评分的变化。结局评估设盲。分析基于意向治疗。结果两组之间哮喘控制或自我效能的变化无显著差异（ACQ：移动的组平均变化0.75 vs纸质组0.73，变化的平均差异为-0.02（95%置信区间为-0.23至0.19）; KASE-AQ评分：平均变化为-4.4 vs-2.4，平均差异为2.0（-0.3至4.2））。两组中发生急性加重、类固醇疗程和计划外咨询的患者数量相似，医疗费用相似。总体而言，由于远程监护的费用，移动的电话服务更昂贵。结论：当两组患者都接受了符合指南标准的临床护理时，与纸质监测相比，移动的技术并不能改善哮喘控制或提高自我效能。移动的技术不符合成本效益。临床试验NCT 00512837的试验注册。
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.
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影响因子：
4.3
作者：
Juniper, EF;Bousquet, J;Bateman, ED
通讯作者：
Bateman, ED
影响因子：
10
作者：
通讯作者：
--
影响因子：
158.5
作者：
Campbell, Stephen;Reeves, David;Roland, Martin
通讯作者：
Roland, Martin
影响因子：
4.3
作者：
Juniper, EF;Svensson, K;Ståhl, E
通讯作者：
Ståhl, E
影响因子：
2.2
作者：
Howie, JGR;Heaney, DJ;Walker, JJ
通讯作者：
Walker, JJ