@文章{信息:doi/10.2196/25879，作者=“Rumi, Gabriele和Canonica, G Walter和Foster, Juliet M和Chavannes, Niels H和Valenti, Giuseppe和连续glia, Rosario和Rapsomaniki, Eleni和Kocks, Janwillem W H和De Brasi, Dario和Braido, Fulvio”，标题=“使用智能吸入器技术改善意大利哮喘患者哮喘管理的数字指导:基于社区的研究”，期刊=“JMIR Mhealth Uhealth”，年=“2022”，月=“11”，日=“2”，卷=“10”，号=“11”，页=“e25879”，关键词=“哮喘控制;哮喘管理;连接设备;数字健康;电子健康;吸入器;维持和缓解治疗;背景:依赖短效$\ β $-2激动剂和不坚持使用维持药物与哮喘的不良临床结果有关。数字健康解决方案可以支持最佳药物使用，从而支持哮喘患者的疾病控制; however, their use in community settings has not been determined. Objective: The primary objective of this study is to investigate community implementation of the Turbu+ program designed to support asthma self-management, including adherence to budesonide and formoterol (Symbicort) Turbuhaler, a combination inhaler for both maintenance therapy or maintenance and reliever therapy. The secondary objective is to provide health care professionals with insights into how patients were using their medication in real life. Methods: Patients with physician-diagnosed asthma were prescribed budesonide and formoterol as maintenance therapy, at a dose of either 1 inhalation twice daily (1-BID) or 2 inhalations twice daily (2-BID), or as maintenance and reliever therapy (1-BID and reliever or 2-BID and reliever in a single inhaler), and they received training on Turbu+ in secondary care centers across Italy. An electronic device attached to the patients' inhaler for ≥90 days (data cutoff) securely uploaded medication use data to a smartphone app and provided reminders, visualized medication use, and motivational nudge messages. Average medication adherence was defined as the proportion of daily maintenance inhalations taken as prescribed (number of recorded maintenance actuations per day or maintenance inhalations prescribed per day) averaged over the monitoring period. The proportion of adherent days was defined as the proportion of days when all prescribed maintenance inhalations were taken on a given day. The Wilcoxon test was used to compare the proportion of adherent days between patients in the maintenance regimen and patients in the maintenance and reliever regimen of a given dose. Results: In 661 patients, the mean (SD) number of days monitored was 217.2 (SD 109.0) days. The average medication adherence (maintenance doses taken/doses prescribed) was 70.2{\%} (108,040/153,820) overall and was similar across the groups (1-BID: 6332/9520, 66.5{\%}; 1‑BID and reliever: 43,578/61,360, 71.0{\%}; 2-BID: 10,088/14,960, 67.4{\%}; 2-BID and reliever: 48,042/67,980, 70.7{\%}). The proportion of adherent days (prescribed maintenance doses/doses taken in a given day) was 56.6{\%} (31,812/56,175) overall and was higher with maintenance and reliever therapy (1-BID and reliever vs 1-BID: 18,413/30,680, 60.0{\%} vs 2510/4760, 52.7{\%}; P<.001; 2-BID and reliever vs 2-BID: 8995/16,995, 52.9{\%} vs 1894/3740, 50.6{\%}; P=.02). Rates of discontinuation from the Turbu+ program were significantly lower with maintenance and reliever therapy compared with maintenance therapy alone (P=.01). Conclusions: Overall, the high medication adherence observed during the study might be attributed to the electronic monitoring and feedback mechanism provided by the Turbu+ program. ", issn="2291-5222", doi="10.2196/25879", url="https://mhealth.www.mybigtv.com/2022/11/e25879", url="https://doi.org/10.2196/25879", url="http://www.ncbi.nlm.nih.gov/pubmed/36322120" }