title: Feasibility of a smartphone application based action plan and monitoring in asthma.
abstract: BACKGROUND
  Asthma patients may experience acute episodic exacerbation. The guidelines recommend that written action plan should be given to asthma patients. However, no one can predict when and where acute exacerbation will happen. As people carry smart phone almost anytime and anywhere, smartphone application could be a useful tool in asthma care. We evaluated the feasibility of the ubiquitous healthcare system of asthma care using a smartphone application (snuCare) based on the self-management guideline or action plan.
  
  
  METHODS
  Forty-four patients including fragile asthmatics were enrolled from Seoul National University Bundang Hospital between December 2011 and February 2012. They were randomly assigned into application user (n = 22) or application nonuser group (n = 22). We evaluated user-satisfaction, and clinical parameters such as asthma control, Quality of Life Questionnaire for Adult Korean Asthmatics, and the adherence of patients.
  
  
  RESULTS
  The characteristics were similar at baseline between the 2 groups except those who treated with short-term systemic steroid or increased dose of systemic steroid during previous 8 weeks (user vs. nonuser: 31.8% vs. 4.5%, p = 0.020). Total of 2,226 signals was generated during 8 weeks including 5 risky states. After eight weeks, the users answered that it was very easy to use the application, which was shown in highest scores in terms of satisfaction (mean ± standard deviation, 4.3 ± 0.56). Seventy-three percent of patients answered that the application was very useful for asthma care. User group showed improved the adherence scores (p = 0.017). One patient in application user group could avoid Emergency Department visit owing to the application while a patient in nonuser group visited Emergency Department.
  
  
  CONCLUSIONS
  The ubiquitous healthcare system using a smartphone application (snuCare) based on the self-management guideline or action plan could be helpful in the monitoring and the management of asthma.
authors.affiliation: Department of Internal Medicine, Inje University College of Medicine, Busan 47392, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.
authors.forename: Mi-Yeong
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
authors.forename: Suh-Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University College of Medicine, Yangsan 50612, Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jo
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
authors.forename: Seung-Eun
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Min-Gyu
authors.initials: MG
authors.lastname: Kang
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Woo-Jung
authors.initials: WJ
authors.lastname: Song
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
authors.forename: Sae-Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Kyung-Up
authors.initials: KU
authors.lastname: Min
authors.affiliation: Technology Development Office, Advanced Institute of Technology, KT R&D center, Seoul 16678, Korea.
authors.forename: Ki-Hwan
authors.initials: KH
authors.lastname: Ahn
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Chang
keywords: Application; Asthma; Mobile medicine; Smartphone; Telemedicine; Ubiquitous health care