Understanding the potential role of mobile phone-based monitoring on asthma self-management: qualitative study.
BACKGROUND
National and international healthcare policy increasingly seeks technological solutions to the challenge of providing care for people with long-term conditions. Novel technologies, however, have the potential to change the dynamics of disease monitoring and self-management. We aimed to explore the opinions and concerns of people with asthma and primary care clinicians on the potential role of mobile phone monitoring technology (transmitting symptoms and peak flows, with immediate feedback of control and reminder of appropriate actions) in supporting asthma self-management.


METHODS
This qualitative study recruited 48 participants (34 adults and teenagers with asthma, 14 asthma nurses and doctors) from primary care in Lothian (Central Scotland) and Kent (South East England). Thirty-nine participated in six focus groups, which included a demonstration of the technology; nine gave in-depth interviews before and after a 4-week trial of the technology.


RESULTS
Participants considered that mobile phone-based monitoring systems can facilitate guided self-management although, paradoxically, may engender dependence on professional/technological support. In the early phases, as patients are learning to accept, understand and control their asthma, this support was seen as providing much-needed confidence. During the maintenance phase, when self-management predominates, patient and professionals were concerned that increased dependence may be unhelpful, although they appreciated that maintaining an on-going record could facilitate consultations.


CONCLUSIONS
Mobile phone-based monitoring systems have the potential to support guided self-management by aiding transition from clinician-supported early phases to effective self-management during the maintenance phase. Continuing development, adoption and formal evaluation of these systems should take account of the insights provided by our data.
Pinnock
H
H
Division of Community Health Sciences: GP Section, University of Edinburgh, Edinburgh, UK. hilary.pinnock@ed.ac.uk
Slack
R
R
Pagliari
C
C
Price
D
D
Sheikh
A
A
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D040421:Cell Phone; D002648:Child; D004739:England; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods; D019114:Remote Consultation / Q000295:instrumentation / Q000379:methods*; D012648:Self Care / Q000295:instrumentation / Q000379:methods*