title: Telehealth to improve asthma control in pregnancy: A randomized controlled trial.
abstract: Poorly controlled asthma during pregnancy is hazardous for both mother and foetus. Better asthma control may be achieved if patients are involved in regular self-monitoring of symptoms and self-management according to a written asthma action plan. Telehealth applications to optimize asthma management and outcomes in pregnant women have not yet been evaluated. This study evaluated the efficacy of a telehealth programme supported by a handheld respiratory device in improving asthma control during pregnancy.
  
  
  
  Pregnant women with asthma (n = 72) from two antenatal clinics in Melbourne, Australia, were randomized to one of two groups: (i) intervention-involving a telehealth programme (management of asthma with supportive telehealth of respiratory function in pregnancy (MASTERY(©) )) supported by a handheld respiratory device and an Android smart phone application (Breathe-easy(©) ) and written asthma action plan or (ii) control-usual care. The primary outcome was change in asthma control at 3 and 6 months (prenatal). Secondary outcomes included changes in quality of life and lung function, and perinatal/neonatal outcomes.
  
  
  
  At baseline, participants' mean (± standard deviation) age was 31.4 ± 4.5 years and gestational age 16.7 ± 3.1 weeks. At 6 months, the MASTERY group had better asthma control (P = 0.02) and asthma-related quality of life (P = 0.002) compared with usual care. There were no significant differences between groups in lung function, unscheduled health-care visits, days off work/study, oral corticosteroid use, or perinatal outcomes. Differences between groups were not significant at 3 months.
  
  
  
  Telehealth interventions supporting self-management are feasible and could potentially improve asthma control and asthma-related quality of life during pregnancy.
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Australia.|Department of Pharmacy Practice, Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia.
authors.forename: Elida
authors.initials: E
authors.lastname: Zairina
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Abramson
authors.affiliation: Department of Respiratory and Sleep Medicine, The Austin Hospital, Heidelberg, Australia.
authors.forename: Christine F
authors.initials: CF
authors.lastname: McDonald
authors.affiliation: Department of Electrical and Computer Systems Engineering, Faculty of Engineering, Monash University, Melbourne, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Electrical and Computer Systems Engineering, Faculty of Engineering, Monash University, Melbourne, Australia.
authors.forename: Thanuja
authors.initials: T
authors.lastname: Dharmasiri
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Australia.
authors.forename: Kay
authors.initials: K
authors.lastname: Stewart
authors.affiliation: Department of Maternal Fetal Medicine, Mercy Hospital for Women, Melbourne, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Walker
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Department of Clinical Haematology, The Alfred Hospital, Melbourne, Australia.
authors.forename: Eldho
authors.initials: E
authors.lastname: Paul
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Australia.
authors.forename: Johnson
authors.initials: J
authors.lastname: George
mesh_terms: D000328:Adult; D001249:Asthma / Q000628:therapy*; D001315:Australia; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D012129:Respiratory Function Tests; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome
keywords: asthma control; pregnant women; quality of life; telehealth