title: Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial.
abstract: OBJECTIVE
  To determine whether mobile phone based monitoring improves asthma control compared with standard paper based monitoring strategies.
  
  
  METHODS
  Multicentre randomised controlled trial with cost effectiveness analysis.
  
  
  METHODS
  UK primary care.
  
  
  METHODS
  288 adolescents and adults with poorly controlled asthma (asthma control questionnaire (ACQ) score ≥ 1.5) from 32 practices.
  
  
  METHODS
  Participants were centrally randomised to twice daily recording and mobile phone based transmission of symptoms, drug use, and peak flow with immediate feedback prompting action according to an agreed plan or paper based monitoring.
  
  
  METHODS
  Changes in scores on asthma control questionnaire and self efficacy (knowledge, attitude, and self efficacy asthma questionnaire (KASE-AQ)) at six months after randomisation. Assessment of outcomes was blinded. Analysis was on an intention to treat basis.
  
  
  RESULTS
  There was no significant difference in the change in asthma control or self efficacy between the two groups (ACQ: mean change 0.75 in mobile group v 0.73 in paper group, mean difference in change -0.02 (95% confidence interval -0.23 to 0.19); KASE-AQ score: mean change -4.4 v -2.4, mean difference 2.0 (-0.3 to 4.2)). The numbers of patients who had acute exacerbations, steroid courses, and unscheduled consultations were similar in both groups, with similar healthcare costs. Overall, the mobile phone service was more expensive because of the expenses of telemonitoring.
  
  
  CONCLUSIONS
  Mobile technology does not improve asthma control or increase self efficacy compared with paper based monitoring when both groups received clinical care to guidelines standards. The mobile technology was not cost effective.
  
  
  BACKGROUND
  Clinical Trials NCT00512837.
authors.affiliation: Academic Centre of Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK. dermotryan@doctors.org.uk
authors.forename: Dermot
authors.initials: D
authors.lastname: Ryan
authors.forename: David
authors.initials: D
authors.lastname: Price
authors.forename: Stan D
authors.initials: SD
authors.lastname: Musgrave
authors.forename: Shweta
authors.initials: S
authors.lastname: Malhotra
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
authors.forename: Dolapo
authors.initials: D
authors.lastname: Ayansina
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
authors.forename: Lionel
authors.initials: L
authors.lastname: Tarassenko
authors.forename: Claudia
authors.initials: C
authors.lastname: Pagliari
authors.forename: Hilary
authors.initials: H
authors.lastname: Pinnock
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000628:therapy; D001294:Attitude to Health; D040421:Cell Phone / Q000191:economics*; D003362:Cost-Benefit Analysis; D037001:Directive Counseling / Q000379:methods; D005260:Female; D015277:Hotlines / Q000191:economics / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods / Q000523:psychology / Q000592:standards; D017063:Outcome Assessment, Health Care; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011320:Primary Health Care / Q000191:economics / Q000379:methods / Q000592:standards; D011788:Quality of Life; D019114:Remote Consultation / Q000191:economics / Q000295:instrumentation; D012648:Self Care / Q000295:instrumentation / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome