title: MyAirCoach: the use of home-monitoring and mHealth systems to predict deterioration in asthma control and the occurrence of asthma exacerbations; study protocol of an observational study.
abstract: Asthma is a variable lung condition whereby patients experience periods of controlled and uncontrolled asthma symptoms. Patients who experience prolonged periods of uncontrolled asthma have a higher incidence of exacerbations and increased morbidity and mortality rates. The ability to determine and to predict levels of asthma control and the occurrence of exacerbations is crucial in asthma management. Therefore, we aimed to determine to what extent physiological, behavioural and environmental data, obtained by mobile healthcare (mHealth) and home-monitoring sensors, as well as patient characteristics, can be used to predict episodes of uncontrolled asthma and the onset of asthma exacerbations.
  
  
  
  In an 1-year observational study, patients will be provided with mHealth and home-monitoring systems to record daily measurements for the first-month (phase I) and weekly measurements during a follow-up period of 11 months (phase II). Our study population consists of 150 patients, aged ≥18 years, with a clinician's diagnosis of asthma, currently on controller medication, with uncontrolled asthma and/or minimally one exacerbation in the past 12 months. They will be enrolled over three participating centres, including Leiden, London and Manchester. Our main outcomes are the association between physiological, behavioural and environmental data and (1) the loss of asthma control and (2) the occurrence of asthma exacerbations.
  
  
  
  This study was approved by the Medical Ethics Committee of the Leiden University Medical Center in the Netherlands and by the NHS ethics service in the UK.
  
  
  
  NCT02774772.
authors.affiliation: Department of Quality of Care, Leiden University Medical Center, Leiden, The Netherlands.|Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Persijn J
authors.initials: PJ
authors.lastname: Honkoop
authors.affiliation: Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science and Centre, The University of Manchester University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Simpson
authors.affiliation: National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonini
authors.affiliation: Department of Quality of Care, Leiden University Medical Center, Leiden, The Netherlands.|Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jiska B
authors.initials: JB
authors.lastname: Snoeck-Stroband
authors.affiliation: National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Meah
authors.affiliation: National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
authors.forename: Kian
authors.initials: K
authors.lastname: Fan Chung
authors.affiliation: National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
authors.forename: Omar S
authors.initials: OS
authors.lastname: Usmani
authors.affiliation: Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science and Centre, The University of Manchester University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Fowler
authors.affiliation: Department of Quality of Care, Leiden University Medical Center, Leiden, The Netherlands.|Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jacob K
authors.initials: JK
authors.lastname: Sont
mesh_terms: D000397:Air Pollution; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001944:Breath Tests; D018450:Disease Progression; D004781:Environmental Exposure; D015444:Exercise; D000072936:Fitness Trackers; D006339:Heart Rate; D006801:Humans; D055118:Medication Adherence; D009426:Netherlands; D009569:Nitric Oxide / Q000032:analysis; D011058:Pollen; D056152:Respiratory Rate; D000073278:Self-Management; D013147:Spirometry; D017216:Telemedicine; D013696:Temperature; D006113:United Kingdom
chemical_list: D009569:Nitric Oxide
keywords: asthma control; asthma exacerbation; ehealth; home-monitoring; mHealth; self-management