TY - JOUR AU - Morita, Plinio Pelegrini AU - Yeung, Melanie S AU - Ferrone, Madonna AU - Taite, Ann K AU - Madeley, Carole AU - Stevens Lavigne, Andrea AU - To, Teresa AU - Lougheed, M Diane AU - Gupta, Samir AU - Day, Andrew G AU - Cafazzo, Joseph A AU - Licskai, Christopher PY - 2019 DA - 2019/01/28 TI -支持哮喘自我管理(呼吸)的以患者为中心的移动医疗系统:设计，开发和利用JO - JMIR移动健康Uhealth SP - e10956 VL - 7 IS - 1kw -智能手机KW -哮喘KW -自我报告KW -自我管理KW -患者依从性KW -远程医疗KW -风险降低行为KW -互联网KW -监测，生理KW -移动应用AB -背景:不受控制的哮喘造成严重的个人和健康系统的负面影响。基于网络的技术，包括智能手机，是实现循证护理和改善患者结果的新手段。目的:本研究的目的是设计、开发和评估基于国际循证临床指南内容的哮喘协同自我管理(CSM)平台(呼吸)的使用。方法:我们设计并开发了一个基于web的移动健康(mHealth)平台，可在智能手机、平板电脑或台式机上使用，采用以用户为中心的设计方法和国际标准化组织认证的质量开发流程。此外，breathe被设想为一个多功能的CSM移动健康平台，内容基于国际临床实践指南，符合国家隐私和安全规范。该系统通过(1)评估哮喘控制，(2)实时访问动态哮喘行动计划，(3)访问实时环境条件，以及(4)降低风险信息，实现了CSM(患者、提供者和呼吸)和哮喘患者的自我监测。数据收集方案收集了12个月的用户数据，在基线、6个月和12个月进行门诊访问。使用结果包括用户与平台的互动、用户印象、自我报告的药物使用、哮喘症状概况、报告的峰值流量测量以及电子邮件提醒的传递和影响。结果:我们招募了138名平均年龄为45.3岁的患者接受呼吸干预。 Majority were female (100/138, 72.5%), had a smartphone (92/138, 66.7%), and had a mean Asthma Control Test score of 18.3 (SD 4.9). A majority reported that breathe helped in the management of their asthma. Moreover, breathe scored 71.1 (SD 18.9) on the System Usability Scale. Overall, 123 patients had complete usage analytics datasets. The platform sent 7.96 reminder emails per patient per week (pppw), patients accessed breathe 3.08 times, journaled symptoms 2.56 times, reported medication usage 0.30 times, and reported peak flow measurements 0.92 times pppw. Furthermore, breathe calculated patients’ action plan zone of control 2.72 times pppw, with patients being in the green (well-controlled) zone in 47.71% (8300/17,396) of the total calculations. Usage analysis showed that 67.5% (83/123) of the participants used the app at week 4 and only 57.7% (71/123) by week 45. Physician visits, email reminders, and aged 50 years and above were associated with higher utilization. Conclusions: Individuals with asthma reported good usability and high satisfaction levels, reacted to breathe notifications, and had confidence in the platform’s assessment of asthma control. Strong utilization was seen at the intervention’s initiation, followed by a rapid reduction in use. Patient reminders, physician visits, and being aged 50 years and above were associated with higher utilization. Trial Registration: ClinicalTrials.gov NCT01964469; https://clinicaltrials.gov/ct2/show/NCT01964469 SN - 2291-5222 UR - http://mhealth.www.mybigtv.com/2019/1/e10956/ UR - https://doi.org/10.2196/10956 UR - http://www.ncbi.nlm.nih.gov/pubmed/30688654 DO - 10.2196/10956 ID - info:doi/10.2196/10956 ER -