Impact of the Implementation of a Telemedicine Program on Patients Diagnosed with Asthma

NCT ID: NCT06116292

Last Updated: 2024-10-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

108 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-01

Study Completion Date

2026-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Introduction: Asthma is one of the most common chronic respiratory diseases worldwide. Despite the extensive knowledge of the condition and available therapeutic options, severe asthmatic patients have poor disease control in 50% of cases.

Objective: To assess the impact of implementing a mobile application (ESTOI) in patients diagnosed with asthma on disease control, treatment adherence, and perceived quality of life.

Methodology: A 52-week randomized clinical trial involving asthma patients receiving care at a highly specialized hospital in Spain. A total of 108 patients will be included and divided into two groups. The intervention group will receive more comprehensive monitoring than usual, including access to the ESTOI application. The Asthma Control Test (ACT) questionnaire will be used as the primary assessment variable. Other variables to be studied include the Inhaler Adherence Test (TAI), the number of exacerbations, peak expiratory flow, exhaled nitric oxide examination, hospital anxiety and depression scale, asthma quality of life questionnaire, forced spirometry parameters (FVC, FEV1, and reversibility), and analytical parameters (eosinophilia and IgE).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Design: A 52-week randomized clinical trial will be conducted, using a single-blind approach, in patients with asthma. There will be two study arms: the control cohort will receive standard care, while the intervention group will also have access to the mobile application (ESTOI).

Setting and Subjects: The study will take place in the pulmonology department of Bellvitge University Hospital in Barcelona, during the years 2024-2026.

Procedure and Instruments: The project will be structured into three visits. During the first visit, all participants will be seen by the pulmonologist at our center for asthma classification, inhaler updates, and requests for additional tests. Subsequently, the control group will receive health education (provided by the asthma specialist nurse) regarding their condition, treatment plan, signs of alarm, action plan, and a review of asthma triggers. On the other hand, intervention group patients, in addition to health education, will be introduced to the ESTOI application database and provided access to the patient portal, where patients will find all the necessary information on asthma management. Both groups will receive a Peakflow meter and instructions on its use and record-keeping.

A nurse will be responsible for managing and monitoring the patients using the application. Patients will also schedule and review the medical records of all patients included in the study and review the data collection notebooks and informed consents. The asthma specialist nurse will be responsible for conducting the questionnaires, collecting data for the Case Report Form (CRF), performing laboratory tests, and conducting respiratory functional tests.

During the three study visits, all included patients will complete the study questionnaires: Asthma Control Test (ACT), Inhaler Adherence Test (TAI), Asthma Quality of Life Questionnaire (AQLQ), and the Hospital Anxiety and Depression Scale (HAD). Afterward, the electronic history of medication dispenses will be reviewed, exhaled nitric oxide (FeNO) will be measured, a spirometry test with bronchodilator response, a control blood test, and an on-site measurement of Peak Expiratory Flow (PEF) using the Peakflow meter will be conducted.

At the end of the first visit, all participants will be scheduled for the next visit and provided with a contact phone number in case the patients have any questions or issues.

Upon completion of the third visit, the intervention group will be given a satisfaction questionnaire for having used the application."

All relevant study data will be recorded in each patient's data collection notebook for subsequent analysis. These notebooks will be stored at the center in a locked room accessible only to the research team. Sociodemographic variables will be collected by the asthma unit nurse during the first study visit.

Information about the current state of asthma will be obtained through questionnaires, respiratory functional tests, laboratory tests, and a review of the patient's medical history.

Data Analysis: Continuous variables will be expressed as mean and standard deviation in case of a normal distribution, and as median and interquartile range in case of a non-normal distribution. Qualitative variables will be presented as frequencies and percentages. For the comparison of continuous variables, analysis of variance (ANOVA) or the Kruskal-Wallis test will be used. The chi-square test will be performed for the analysis of the primary outcome variable. Stepwise logistic regression models will be used to select the subgroup of parameters significantly associated with poor asthma control. A priori, the factors included in the analysis will be age, asthma duration, education level, BMI, smoking, environmental exposure, pre-BD FEV1, post-BD FEV1, FeNO, blood eosinophilia, general and specific blood IgE levels, ACT, TAI, HAD, AQLQ, the number of exacerbations, and control of comorbidities affecting asthma (GERD, rhinitis, polyps, overweight/obesity, and smoking). Statistical significance will be assumed at p \< 0.05.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Asthma Telemedicine Adherence, Treatment Quality of Life Control

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Mobile application ESTOI for Asthmatic patients

The intervention group will receive the usual care, in addition to having access to the ESTOI application.

Group Type EXPERIMENTAL

The mobile application ESTOI for Asthmatic patients

Intervention Type DEVICE

The mobile application ESTOI have various sections that can be managed and customized by the researchers to meet each patient's needs:

1. SYMPTOM CONTROL, it will record the ACT, TAI, the number of exacerbations, weight, and, depending on the case, symptom control for comorbidities.
2. RECOMMENDATIONS, it will provide patients with information needed to understand their condition, how to control it, and what to do in case of worsening symptoms.
3. YOUR TREATMENT, it will display personalized and update information about the patient's current asthma medication, including dosages and frequencies. There will be explanatory videos on how to administer the therapy and includes an action plan.
4. PEAK FLOW, the patient can record measurements using a Peak Flow Meter at home.
5. NUTRITIONAL PLAN, it will provide a daily dietary guide to enable individuals to adapt these tools and recommendations to their specific needs.
6. MESSAGING, it is a bidirectional contact area.

Standard of care

The intervention group will receive the usual care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

The mobile application ESTOI for Asthmatic patients

The mobile application ESTOI have various sections that can be managed and customized by the researchers to meet each patient's needs:

1. SYMPTOM CONTROL, it will record the ACT, TAI, the number of exacerbations, weight, and, depending on the case, symptom control for comorbidities.
2. RECOMMENDATIONS, it will provide patients with information needed to understand their condition, how to control it, and what to do in case of worsening symptoms.
3. YOUR TREATMENT, it will display personalized and update information about the patient's current asthma medication, including dosages and frequencies. There will be explanatory videos on how to administer the therapy and includes an action plan.
4. PEAK FLOW, the patient can record measurements using a Peak Flow Meter at home.
5. NUTRITIONAL PLAN, it will provide a daily dietary guide to enable individuals to adapt these tools and recommendations to their specific needs.
6. MESSAGING, it is a bidirectional contact area.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age ≥18 years with a diagnosis of asthma based on GEMA 5.2 2022.
* Patients seen in the pulmonology service of the center.
* Patients who have not previously received asthma education.
* Capable of giving signed informed consent.

Exclusion Criteria

* Patient who does not have a mobile device with Android or IOS system.
* Lack of minimum technological knowledge for the use of the application (ESTOI).
* People who are participating or have participated in a clinical trial in the last 6 months.
* Patients diagnosed with other respiratory diseases except for obstructive sleep apnea (OSA), Asthma-COPD overlap syndrome (ACOS).
* Patients with palliative or severe chronic illnesses that limit their life expectancy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hospital Universitari de Bellvitge

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Héctor Cabrerizo Carreño

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Héctor Cabrerizo Carreño, M.N

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitari de Bellvitge

Mariana M Muñoz, M.D.

Role: STUDY_DIRECTOR

Hospital Universitari de Bellvitge

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Bellvitge University Hospital

Barcelona, Barcelona, Spain

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Spain

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Héctor Cabrerizo Carreño, M.N

Role: CONTACT

+34 677281333

References

Explore related publications, articles, or registry entries linked to this study.

GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017 Sep;5(9):691-706. doi: 10.1016/S2213-2600(17)30293-X. Epub 2017 Aug 16.

Reference Type BACKGROUND
PMID: 28822787 (View on PubMed)

Plaza V, Quirce S, Delgado J, Martinez Moragon E, Perez de Llano L; Grupo multidisciplinar de expertos "Asmaforum". [Multidisciplinary expert discussion. Uncontrolled asthma: causes, consequences and possible solutions]. An Sist Sanit Navar. 2016 Nov 21;39(3):357-370. doi: 10.23938/ASSN.0233. Spanish.

Reference Type BACKGROUND
PMID: 28032871 (View on PubMed)

Rabe KF, Adachi M, Lai CK, Soriano JB, Vermeire PA, Weiss KB, Weiss ST. Worldwide severity and control of asthma in children and adults: the global asthma insights and reality surveys. J Allergy Clin Immunol. 2004 Jul;114(1):40-7. doi: 10.1016/j.jaci.2004.04.042.

Reference Type BACKGROUND
PMID: 15241342 (View on PubMed)

Quirce S, Plaza V, Picado C, Vennera M, Casafont J. Prevalence of uncontrolled severe persistent asthma in pneumology and allergy hospital units in Spain. J Investig Allergol Clin Immunol. 2011;21(6):466-71.

Reference Type BACKGROUND
PMID: 21995180 (View on PubMed)

Almonacid Sanchez C, Blanco Aparicio M, Dominguez Ortega J, Giner Donaire J, Molina Paris J, Sanchez Marcos N, Plaza V. [Multidisciplinary Consensus for the Monitoring and Control of Asthma Through Telemedicine. The COMETA Project]. Open Respir Arch. 2021 Apr 19;3(2):100098. doi: 10.1016/j.opresp.2021.100098. eCollection 2021 Apr-Jun. Spanish.

Reference Type BACKGROUND
PMID: 37497073 (View on PubMed)

Marcano Belisario JS, Huckvale K, Greenfield G, Car J, Gunn LH. Smartphone and tablet self management apps for asthma. Cochrane Database Syst Rev. 2013 Nov 27;2013(11):CD010013. doi: 10.1002/14651858.CD010013.pub2.

Reference Type BACKGROUND
PMID: 24282112 (View on PubMed)

Hollenbach JP, Cushing A, Melvin E, McGowan B, Cloutier MM, Manice M. Understanding clinicians' attitudes toward a mobile health strategy to childhood asthma management: A qualitative study. J Asthma. 2017 Sep;54(7):754-760. doi: 10.1080/02770903.2016.1263649. Epub 2016 Nov 23.

Reference Type BACKGROUND
PMID: 27880049 (View on PubMed)

Munteanu LA, Frandes M, Timar B, Tudorache E, Fildan AP, Oancea C, Tofolean DE. The efficacy of a mobile phone application to improve adherence to treatment and self-management in people with chronic respiratory disease in Romanian population - a pilot study. BMC Health Serv Res. 2020 May 27;20(1):475. doi: 10.1186/s12913-020-05340-0.

Reference Type BACKGROUND
PMID: 32460752 (View on PubMed)

Guan Z, Sun L, Xiao Q, Wang Y. Constructing an assessment framework for the quality of asthma smartphone applications. BMC Med Inform Decis Mak. 2019 Oct 15;19(1):192. doi: 10.1186/s12911-019-0923-8.

Reference Type BACKGROUND
PMID: 31615493 (View on PubMed)

Farzandipour M, Nabovati E, Heidarzadeh Arani M, Akbari H, Sharif R, Anvari S. Enhancing Asthma Patients' Self-Management through Smartphone-Based Application: Design, Usability Evaluation, and Educational Intervention. Appl Clin Inform. 2019 Oct;10(5):870-878. doi: 10.1055/s-0039-1700866. Epub 2019 Nov 13.

Reference Type BACKGROUND
PMID: 31724144 (View on PubMed)

Morrison D, Wyke S, Agur K, Cameron EJ, Docking RI, Mackenzie AM, McConnachie A, Raghuvir V, Thomson NC, Mair FS. Digital asthma self-management interventions: a systematic review. J Med Internet Res. 2014 Feb 18;16(2):e51. doi: 10.2196/jmir.2814.

Reference Type BACKGROUND
PMID: 24550161 (View on PubMed)

Thomas M, Kay S, Pike J, Williams A, Rosenzweig JR, Hillyer EV, Price D. The Asthma Control Test (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey. Prim Care Respir J. 2009 Mar;18(1):41-9. doi: 10.4104/pcrj.2009.00010.

Reference Type BACKGROUND
PMID: 19240948 (View on PubMed)

Plaza V, Fernandez-Rodriguez C, Melero C, Cosio BG, Entrenas LM, de Llano LP, Gutierrez-Pereyra F, Tarragona E, Palomino R, Lopez-Vina A; TAI Study Group. Validation of the 'Test of the Adherence to Inhalers' (TAI) for Asthma and COPD Patients. J Aerosol Med Pulm Drug Deliv. 2016 Apr;29(2):142-52. doi: 10.1089/jamp.2015.1212. Epub 2015 Jul 31.

Reference Type BACKGROUND
PMID: 26230150 (View on PubMed)

Perpina M, Belloch A, Pascual LM, de Diego A, Compte L. [The quality of life in asthma: an evaluation of the AQLQ questionnaire for its use on a Spanish population. Asthma Quality of Life Questionnaire]. Arch Bronconeumol. 1995 May;31(5):211-8. doi: 10.1016/s0300-2896(15)30926-1. Spanish.

Reference Type BACKGROUND
PMID: 7788082 (View on PubMed)

Reddel HK, Marks GB, Jenkins CR. When can personal best peak flow be determined for asthma action plans? Thorax. 2004 Nov;59(11):922-4. doi: 10.1136/thx.2004.023077.

Reference Type BACKGROUND
PMID: 15516464 (View on PubMed)

Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, Jensen R, Johnson DC, MacIntyre N, McKay R, Miller MR, Navajas D, Pedersen OF, Wanger J. Interpretative strategies for lung function tests. Eur Respir J. 2005 Nov;26(5):948-68. doi: 10.1183/09031936.05.00035205. No abstract available.

Reference Type BACKGROUND
PMID: 16264058 (View on PubMed)

Lu Z, Huang W, Wang L, Xu N, Ding Q, Cao C. Exhaled nitric oxide in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2018 Aug 30;13:2695-2705. doi: 10.2147/COPD.S165780. eCollection 2018.

Reference Type BACKGROUND
PMID: 30214187 (View on PubMed)

Schatz M, Kosinski M, Yarlas AS, Hanlon J, Watson ME, Jhingran P. The minimally important difference of the Asthma Control Test. J Allergy Clin Immunol. 2009 Oct;124(4):719-23.e1. doi: 10.1016/j.jaci.2009.06.053. Epub 2009 Sep 19.

Reference Type BACKGROUND
PMID: 19767070 (View on PubMed)

Kolmodin MacDonell K, Naar S, Gibson-Scipio W, Lam P, Secord E. The Detroit Young Adult Asthma Project: Pilot of a Technology-Based Medication Adherence Intervention for African-American Emerging Adults. J Adolesc Health. 2016 Oct;59(4):465-71. doi: 10.1016/j.jadohealth.2016.05.016. Epub 2016 Jul 27.

Reference Type BACKGROUND
PMID: 27475032 (View on PubMed)

Patel MR, Song PX, Sanders G, Nelson B, Kaltsas E, Thomas LJ, Janevic MR, Hafeez K, Wang W, Wilkin M, Johnson TR, Brown RW. A randomized clinical trial of a culturally responsive intervention for African American women with asthma. Ann Allergy Asthma Immunol. 2017 Feb;118(2):212-219. doi: 10.1016/j.anai.2016.11.016. Epub 2016 Dec 27.

Reference Type BACKGROUND
PMID: 28034579 (View on PubMed)

Kim MY, Lee SY, Jo EJ, Lee SE, Kang MG, Song WJ, Kim SH, Cho SH, Min KU, Ahn KH, Chang YS. Feasibility of a smartphone application based action plan and monitoring in asthma. Asia Pac Allergy. 2016 Jul;6(3):174-80. doi: 10.5415/apallergy.2016.6.3.174. Epub 2016 Jul 28.

Reference Type BACKGROUND
PMID: 27489790 (View on PubMed)

Zairina E, Abramson MJ, McDonald CF, Li J, Dharmasiri T, Stewart K, Walker SP, Paul E, George J. Telehealth to improve asthma control in pregnancy: A randomized controlled trial. Respirology. 2016 Jul;21(5):867-74. doi: 10.1111/resp.12773. Epub 2016 Mar 31.

Reference Type BACKGROUND
PMID: 27037722 (View on PubMed)

Pool AC, Kraschnewski JL, Poger JM, Smyth J, Stuckey HL, Craig TJ, Lehman EB, Yang C, Sciamanna CN. Impact of online patient reminders to improve asthma care: A randomized controlled trial. PLoS One. 2017 Feb 3;12(2):e0170447. doi: 10.1371/journal.pone.0170447. eCollection 2017.

Reference Type BACKGROUND
PMID: 28158200 (View on PubMed)

Khusial RJ, Honkoop PJ, Usmani O, Soares M, Simpson A, Biddiscombe M, Meah S, Bonini M, Lalas A, Polychronidou E, Koopmans JG, Moustakas K, Snoeck-Stroband JB, Ortmann S, Votis K, Tzovaras D, Chung KF, Fowler S, Sont JK; myAirCoach study group. Effectiveness of myAirCoach: A mHealth Self-Management System in Asthma. J Allergy Clin Immunol Pract. 2020 Jun;8(6):1972-1979.e8. doi: 10.1016/j.jaip.2020.02.018. Epub 2020 Mar 3.

Reference Type BACKGROUND
PMID: 32142961 (View on PubMed)

Cao Y, Lin SH, Zhu D, Xu F, Chen ZH, Shen HH, Li W. WeChat Public Account Use Improves Clinical Control of Cough-Variant Asthma: A Randomized Controlled Trial. Med Sci Monit. 2018 Mar 14;24:1524-1532. doi: 10.12659/msm.907284.

Reference Type BACKGROUND
PMID: 29536984 (View on PubMed)

Prabhakaran L, Chun Wei Y. Effectiveness of the eCARE programme: a short message service for asthma monitoring. BMJ Health Care Inform. 2019 Jun;26(1):e100007. doi: 10.1136/bmjhci-2019-100007.

Reference Type BACKGROUND
PMID: 31201202 (View on PubMed)

Nemanic T, Sarc I, Skrgat S, Flezar M, Cukjati I, Marc Malovrh M. Telemonitoring in asthma control: a randomized controlled trial. J Asthma. 2019 Jul;56(7):782-790. doi: 10.1080/02770903.2018.1493599. Epub 2018 Sep 5.

Reference Type BACKGROUND
PMID: 30063840 (View on PubMed)

Ahmed S, Ernst P, Bartlett SJ, Valois MF, Zaihra T, Pare G, Grad R, Eilayyan O, Perreault R, Tamblyn R. The Effectiveness of Web-Based Asthma Self-Management System, My Asthma Portal (MAP): A Pilot Randomized Controlled Trial. J Med Internet Res. 2016 Dec 1;18(12):e313. doi: 10.2196/jmir.5866.

Reference Type BACKGROUND
PMID: 27908846 (View on PubMed)

Koufopoulos JT, Conner MT, Gardner PH, Kellar I. A Web-Based and Mobile Health Social Support Intervention to Promote Adherence to Inhaled Asthma Medications: Randomized Controlled Trial. J Med Internet Res. 2016 Jun 13;18(6):e122. doi: 10.2196/jmir.4963.

Reference Type BACKGROUND
PMID: 27298211 (View on PubMed)

Chongmelaxme B, Lee S, Dhippayom T, Saokaew S, Chaiyakunapruk N, Dilokthornsakul P. The Effects of Telemedicine on Asthma Control and Patients' Quality of Life in Adults: A Systematic Review and Meta-analysis. J Allergy Clin Immunol Pract. 2019 Jan;7(1):199-216.e11. doi: 10.1016/j.jaip.2018.07.015. Epub 2018 Jul 25.

Reference Type BACKGROUND
PMID: 30055283 (View on PubMed)

Cabrerizo-Carreno H, Munoz-Esquerre M, Santos Perez S, Romero-Ortiz AM, Fabrellas N, Guix-Comellas EM. Impact of the implementation of a telemedicine program on patients diagnosed with asthma. BMC Pulm Med. 2024 Jan 13;24(1):32. doi: 10.1186/s12890-024-02843-y.

Reference Type DERIVED
PMID: 38216971 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

https://linkinghub.elsevier.com/retrieve/pii/S0140673620309259

Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

TAPR-578/24

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Asthma Research in Children and Adolescents
NCT04480242 ACTIVE_NOT_RECRUITING
Telecommunications System in Asthma
NCT00232557 COMPLETED PHASE3
The Virtual Asthma Clinic
NCT00562081 TERMINATED PHASE4