A mobile phone short message service improves perceived control of asthma: a randomized controlled trial.

OBJECTIVE Mobile phone short message service (SMS) has been suggested as a potentially powerful tool to improve asthma outcomes, and it can overcome external barriers such as time and distance to participate education programs. We wanted to know whether SMS can help to overcome intrinsic barriers such as perceived control of asthma (PCA). SUBJECTS AND METHODS One hundred fifty outpatients with asthma were randomly assigned to the control, traditional, and SMS groups. Patients in all groups received verbal education based on the Global Initiative for Asthma, and patients in the traditional group received additional individualized asthma action plan for self-management with peak expiratory flow monitoring and recording asthma diary, while patients in the SMS group received additional daily SMS reminders on their mobile phone. The six-item PCA Questionnaire (PCAQ-6), Standard Asthma-Specific Quality of Life [AQLQ(S)], spirometry, blood and induced sputum cell count, follow-up compliance rate, medicine compliance rate, and emergency department (ED) visits data were collected at the initial visit and at 12 weeks. RESULTS In total, 71 participants completed the trial for analysis. Patients' PCAQ-6 score was significantly increased in the SMS and traditional groups (p<0.001) after 12 weeks, and the change of patients' PCAQ-6 score in the SMS group was higher than in the traditional group (p=0.018). Patients in the SMS group had the highest AQLQ(S) score and follow-up rate after 12 weeks. The change in PCAQ-6 score was associated with change in AQLQ(S) score (r=0.442). Patients in all groups had better forced expiratory volume in 1 s (FEV1%) and fewer ED visits after 12 weeks, but no significant differences were found among the three groups in the changes of FEV1% and blood and induced sputum eosinophil counts and neutrophil counts. CONCLUSIONS SMS can improve PCA, and it has a greater advantage in improving follow-up rate and asthma-specific quality of life than traditional programs.

[1]  David H. Wilson,et al.  Psychological factors and asthma quality of life: a population based study , 2004, Thorax.

[2]  A. Calle-Pascual,et al.  A Telemedicine system based on Internet and short message service as a new approach in the follow-up of patients with gestational diabetes. , 2010, Diabetes research and clinical practice.

[3]  R. Guy,et al.  Short message service reminder intervention doubles sexually transmitted infection/HIV re-testing rates among men who have sex with men , 2011, Sexually Transmitted Infections.

[4]  H. Kerstjens,et al.  Accuracy of eosinophils and eosinophil cationic protein to predict steroid improvement in asthma , 2002, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[5]  M J Hensley,et al.  Self-management education and regular practitioner review for adults with asthma. , 2002, The Cochrane database of systematic reviews.

[6]  R. Dahl,et al.  Assessment of asthma control and its impact on optimal treatment strategy , 2007, Allergy.

[7]  S. Janson,et al.  Individualized asthma self-management improves medication adherence and markers of asthma control. , 2009, The Journal of allergy and clinical immunology.

[8]  H. Kuo,et al.  A mobile telephone-based interactive self-care system improves asthma control , 2010, European Respiratory Journal.

[9]  E. Yelin,et al.  Perceived control of asthma and quality of life among adults with asthma. , 2002, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[10]  L. Boulet,et al.  Treatment adherence and psychosocial factors in severe asthma , 2011 .

[11]  M. Lougheed,et al.  Perceived Control and Quality of Life in Asthma: Impact of Asthma Education , 2005, The Journal of asthma : official journal of the Association for the Care of Asthma.

[12]  A. Buist,et al.  Validation of a standardized version of the Asthma Quality of Life Questionnaire. , 1999, Chest.

[13]  G. Verleden,et al.  Understanding participation in an asthma self-management program. , 2005, Chest.

[14]  Christine C Johnson,et al.  Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma. , 2004, The Journal of allergy and clinical immunology.

[15]  M. Charlson,et al.  Self-Efficacy, Depressive Symptoms, and Patients’ Expectations Predict Outcomes in Asthma , 2001, Medical care.

[16]  M. Lougheed,et al.  Outcomes of asthma education: results of a multisite evaluation. , 2004, Canadian respiratory journal.

[17]  S. Wade,et al.  The relationship between psychosocial factors and asthma morbidity in inner-city children with asthma. , 1999, Pediatrics.

[18]  M. Dimatteo Variations in Patients’ Adherence to Medical Recommendations: A Quantitative Review of 50 Years of Research , 2004, Medical care.

[19]  H. Rhee,et al.  Barriers to asthma self‐management in adolescents: Relationships to psychosocial factors , 2009, Pediatric pulmonology.

[20]  Linda G. Kimmel,et al.  A 6-item brief measure for assessing perceived control of asthma in culturally diverse patients. , 2007, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[21]  Kevin B Weiss,et al.  Worldwide severity and control of asthma in children and adults: the global asthma insights and reality surveys. , 2004, The Journal of allergy and clinical immunology.

[22]  Vibeke Backer,et al.  A daily SMS reminder increases adherence to asthma treatment: a three-month follow-up study. , 2010, Respiratory medicine.

[23]  C. Iribarren,et al.  The influence of perceived control of asthma on health outcomes. , 2006, Chest.

[24]  P. J. Barnes,et al.  Global strategy for asthma management and prevention: GINA executive summary , 2008, European Respiratory Journal.

[25]  R. Pill,et al.  Qualitative study of views of health professionals and patients on guided self management plans for asthma , 2000, BMJ : British Medical Journal.

[26]  F. Hargreave,et al.  Sputum eosinophil count to assess compliance with corticosteroid therapy in asthma. , 1999, The Journal of allergy and clinical immunology.

[27]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[28]  W. Jack,et al.  Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial , 2010, The Lancet.