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A Systematic Review and Meta-Analysis of Change in Health-Related Quality of Life for Interactive Telehealth Interventions for Patients With Asthma

  • Centaine L. Snoswell
    Correspondence
    Correspondence: Centaine L. Snoswell, PhD, MPH, BPharm, Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital Campus, Cornwall St, Woolloongabba, Brisbane, Queensland, Australia, 4102.
    Affiliations
    Centre for Online Health, The University of Queensland, Brisbane, Australia

    Centre for Health Services Research, The University of Queensland, Brisbane, Australia

    Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia
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  • Miia Rahja
    Affiliations
    Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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  • Aislinn F. Lalor
    Affiliations
    Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia

    Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
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Published:October 23, 2020DOI:https://doi.org/10.1016/j.jval.2020.09.006

      Abstract

      Objectives

      Asthma is one of the most common major noncommunicable diseases in the world and affects individuals of all ages. Medication is used to achieve and maintain quality of life (QOL) for people with asthma. Telehealth interventions offer optimized and personalized symptom monitoring with timely treatment adjustment and the potential to increase medication adherence for individuals with asthma. This study examines and synthesizes the available data on the change in the QOL for patients with asthma who use interactive telehealth interventions, and identifies the most effective telehealth modalities used for intervention in this area.

      Methods

      Literature searches were conducted in 5 databases in November 2018 for studies measuring a change in QOL for patients with asthma. Study QOL outcomes, where possible, were pooled in a meta-analysis.

      Results

      Seventeen publications (describing 16 studies) comprising 2015 patients were included. Based on a meta-analysis, interactive telehealth interventions can improve QOL outcomes for people living with asthma, although the improved effects may be small: web portals (0.51, 95% confidence interval [CI] –0.00 to 1.03), interactive smartphone apps (0.30, 95% CI –0.16 to 0.76) and remote monitoring (standardized mean difference 0.20, 95% CI –0.11 to 0.52). Intervention delivery modalities identified include interactive web portals, smartphone apps, and remote monitoring programs.

      Conclusions

      The findings provide a comprehensive overview of the available literature on interactive telehealth interventions, including interactive web portals, smartphone apps, and remote monitoring programs. These findings demonstrated that a positive change in QOL can be attributed to these interventions and provide evidence for the implementation of telehealth interventions for individuals with asthma.

      Keywords

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      References

        • Dharmage S.C.
        • Perret J.L.
        • Custovic A.
        Epidemiology of asthma in children and adults.
        Front Pediatr. 2019; 7: 246
        • Croisant S.
        Epidemiology of asthma: prevalence and burden of disease.
        Adv Exp Med Biol. 2014; 795: 17-29
        • National Asthma Council Australia
        Australian asthma handbook, version 2.0.
        http://www.asthmahandbook.org.au
        Date accessed: January 10, 2020
        • Dunne M.
        • Hughes M.
        How does asthma affect the day-to-day life of sufferers?.
        Eur Respir J. 2015; 46: PA336
        • Global Asthma Network
        The Global Asthma Report 2018.
        Global Asthma Network, Auckland, New Zealand2018
        • WHOQOL Group
        Measuring Quality of Life: The Development of the World Health Organization Quality of Life Instrument (WHOQoL).
        World Health Organization, Geneva, Switzerland1993
        • World Health Organization
        Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020.
        World Health Organization, Geneva, Switzerland2013
        • Meskó B.
        • Drobni Z.
        • Bényei É.
        • Gergely B.
        • Győrffy Z.
        Digital health is a cultural transformation of traditional healthcare.
        Mhealth. 2017; 3: 38
        • Chongmelaxme B.
        • Lee S.
        • Dhippayom T.
        • Saokaew S.
        • Chaiyakunapruk N.
        • Dilokthornsakul P.
        The effects of telemedicine on asthma control and patients’ quality of life in adults: a systematic review and meta-analysis.
        J Allergy Clin Immunol Pract. 2019; 7: 199-216.e111
        • McLean G.
        • Murray E.
        • Band R.
        • et al.
        Interactive digital interventions to promote self-management in adults with asthma: systematic review and meta-analysis.
        BMC Pulm Med. 2016; 16: 83
        • McLean S.
        • Chandler D.
        • Nurmatov U.
        • et al.
        Telehealthcare for asthma: a Cochrane review.
        CMAJ. 2011; 183: E733-E742
        • Morrison D.
        • Wyke S.
        • Agur K.
        • et al.
        Digital asthma self-management interventions: a systematic review.
        J Med Internet Res. 2014; 16: e51
        • Snoswell C.L.
        The effect of digital health interventions on health related quality of life. PROSPERO.
        • Ogrinc G.
        • Davies L.
        • Goodman D.
        • Batalden P.
        • Davidoff F.
        • Stevens D.
        SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process.
        BMJ Qual Saf. 2016; 25: 986-992
        • Egger M.
        • Smith G.D.
        • Schneider M.
        • Minder C.
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ. 1997; 315: 629-634
        • Ahmed S.
        • Ernst P.
        • Bartlett S.J.
        • et al.
        The effectiveness of web-based asthma self-management system, My Asthma Portal (MAP): a pilot randomized controlled trial.
        J Med Internet Res. 2016; 18: e313
        • Araujo L.
        • Jacinto T.
        • Moreira A.
        • et al.
        Clinical efficacy of web-based versus standard asthma self-management.
        J Investig Allergol Clin Immunol. 2012; 22: 28-34
        • Kim M.Y.
        • Lee S.Y.
        • Jo E.J.
        • et al.
        Feasibility of a smartphone application based action plan and monitoring in asthma.
        Asia Pac Allergy. 2016; 6: 174-180
        • Rasmussen L.M.
        • Phanareth K.
        • Nolte H.
        • Backer V.
        Internet-based monitoring of asthma: a long-term, randomized clinical study of 300 asthmatic subjects.
        J Investig Allergol Clin Immunol. 2005; 115: 1137-1142
        • Van der Meer V.
        • Bakker M.J.
        • van den Hout W.B.
        • et al.
        Internet-based self-management plus education compared with usual care in asthma: a randomized trial.
        Ann Intern Med. 2009; 151: 110-120
        • van Gaalen J.L.
        • Beerthuizen T.
        • van der Meer V.
        • et al.
        Long-term outcomes of internet-based self-management support in adults with asthma: randomized controlled trial.
        J Med Internet Res. 2013; 15: e188
        • Zairina E.
        • Abramson M.J.
        • McDonald C.F.
        • et al.
        Telehealth to improve asthma control in pregnancy: a randomized controlled trial.
        Respirology. 2016; 21: 867-874
        • Chan D.S.
        • Callahan C.W.
        • Hatch-Pigott V.B.
        • et al.
        Internet-based home monitoring and education of children with asthma is comparable to ideal office-based care: results of a 1-year asthma in-home monitoring trial.
        Pediatrics. 2007; 119: 569-578
        • Chan D.S.
        • Callahan C.W.
        • Sheets S.J.
        • Moreno C.N.
        • Malone F.J.
        An Internet-based store-and-forward video home telehealth system for improving asthma outcomes in children.
        Am J Health Syst Pharm. 2003; 60: 1976-1981
        • Deschildre A.
        • Beghin L.
        • Salleron J.
        • et al.
        Home telemonitoring (forced expiratory volume in 1 s) in children with severe asthma does not reduce exacerbations.
        Eur Respir J. 2012; 39: 290-296
        • Halterman J.S.
        • Fagnano M.
        • Tajon R.S.
        • et al.
        Effect of the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program on asthma morbidity: a randomized clinical trial.
        JAMA Pediatr. 2018; 172e174938
        • Jan R.L.
        • Wang J.Y.
        • Huang M.C.
        • Tseng S.M.
        • Su H.J.
        • Liu L.F.
        An internet-based interactive telemonitoring system for improving childhood asthma outcomes in Taiwan.
        Telemedicine J E Health. 2007; 13: 257-268
        • Rikkers-Mutsaerts E.R.
        • Winters A.E.
        • Bakker M.J.
        • et al.
        Internet-based self-management compared with usual care in adolescents with asthma: a randomized controlled trial.
        Pediatr Pulmonol. 2012; 47: 1170-1179
        • Liu W.-T.
        • Huang C.-D.
        • Wang C.-H.
        • Lee K.-Y.
        • Lin S.-M.
        • Kuo H.-P.
        A mobile telephone-based interactive self-care system improves asthma control.
        Eur Resp J. 2011; 37: 310-317
        • Ryan D.
        • Price D.
        • Musgrave S.D.
        • et al.
        Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial.
        BMJ. 2012; 344: e1756
        • Van Der Meer V.
        • Van Den Hout W.B.
        • Bakker M.J.
        • et al.
        Cost-effectiveness of Internet-based self-management compared with usual care in asthma.
        PLoS One. 2011; 6e27108
        • Willems D.C.
        • Joore M.A.
        • Hendriks J.J.
        • Nieman F.H.
        • Severens J.L.
        • Wouters E.F.
        The effectiveness of nurse-led telemonitoring of asthma: results of a randomized controlled trial.
        J Eval Clin Pract. 2008; 14: 600-609
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6e1000097
        • Juniper E.
        • Guyatt G.
        • Willan A.
        • Griffith L.
        Determining a minimal important change in a disease-specific quality of life instrument.
        J Clin Epidemiol. 1994; 47: 81-87
        • Juniper E.
        • Guyatt G.
        • Cox F.
        • Ferrie P.
        • King D.
        Development and validation of the Mini Asthma Quality of Life Questionnaire.
        Eur Respir J. 1999; 14: 32-38
        • Juniper E.
        • Guyatt G.
        • Feeny D.
        • Ferrie P.
        • Griffith L.
        • Townsend M.
        Measuring quality of life in children with asthma.
        Qual Life Res. 1996; 5: 35-46
        • Park J.W.
        • Cho Y.S.
        • Lee S.Y.
        • et al.
        Multi-center study for the utilization of quality of life questionnaire for adult Korean asthmatics (QLQAKA).
        J Asthma Allergy Clin Immunol. 2000; 20: 467
        • Ware Jr., J.
        • Kosinski M.
        • Keller S.D.
        A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.
        Med Care. 1996; 34: 220-233
        • Nathan R.A.
        • Sorkness C.A.
        • Kosinski M.
        • et al.
        Development of the asthma control test: a survey for assessing asthma control.
        J Allergy Clin Immunol. 2004; 113: 59-65
        • Juniper E.F.
        • O’Byrne P.M.
        • Guyatt G.H.
        • Ferrie P.J.
        • King D.R.
        Development and validation of a questionnaire to measure asthma control.
        Eur Respir J. 1999; 14: 902-907
        • Labrique A.B.
        • Vasudevan L.
        • Kochi E.
        • Fabricant R.
        • Mehl G.
        mHealth innovations as health system strengthening tools: 12 common applications and a visual framework.
        Glob Health Sci Pract. 2013; 1: 160-171
        • Steinhubl S.R.
        • Muse E.D.
        • Topol E.J.
        Can mobile health technologies transform health care?.
        JAMA. 2013; 310: 2395-2396
        • Jiang X.
        • Ming W.-K.
        • You J.H.S.
        The cost-effectiveness of digital health interventions on the management of cardiovascular diseases: systematic review.
        J Med Internet Res. 2019; 21e13166
        • Iribarren S.J.
        • Cato K.
        • Falzon L.
        • Stone P.W.
        What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions.
        PLoS One. 2017; 12e0170581