Annotated Bibliographies
Annotated Bibliography 1
Source #1: Ryan, Dermot, et al. “Clinical and Cost Effectiveness of Mobile Phone Supported Self Monitoring of Asthma: Multicentre Randomised Controlled Trial.” The BMJ, British Medical Journal Publishing Group, 23 Mar. 2012, www.bmj.com/content/344/bmj.e1756.
This journal’s goal was to determine whether mobile phone based monitoring improves asthma control compared with standard paper based monitoring strategies. 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.There was no significant difference in the change in asthma control or self efficacy between the two groups .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. 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.
Quotes:
“Figure 2 shows the flow of patients through the trial. From 32 practices (total list size 311 926) computer searches identified a potentially eligible population of 13 101 (mean (SD) age 48.2 (17.9): 63% female), of whom 1020 were excluded by their practice. A total of 12 081 postal invitations were issued: 1016 people (8.4%) expressed an interest in participating and were prescreened for eligibility (poor control and compatible mobile phone and network). The 393 potentially eligible patients were invited to attend the baseline assessment and 288 gave informed consent and were randomised: 145 to the mobile group and 143 to the paper group. Ten people had missing or incomplete ACQ scores at baseline and were excluded after randomisation, leaving 139 patients in each group for the intention to treat analysis.”
“Similarly, the intention to treat analysis showed no significant difference between the groups in change in mini-AQLQ score (table 2⇑), though more patients in the mobile group improved their quality of life by more than the minimum important difference than in the paper group (table 3⇑).”
“In both groups the median number of asthma consultations was two, with 37% of the patients in both groups attending only the baseline and one follow-up appointment (table 4⇓). Most patients in both groups had increased treatment with asthma drugs according to the BTS-SIGN treatment steps (82 (59%) in the mobile group and 74 (55%) in the paper group), and the nine patients not treated according to BTS-SIGN steps at baseline were receiving a recommended treatment schedule by the end of the trial (fig 4⇓). There was no significant difference between the groups in the number of acute attacks, steroid courses prescribed, unscheduled GP or nurse consultations, out of hours visits, attendances at emergency department, or admissions (table 5⇓).”
Assessment: This source is reliable since it is written by Dermot Ryan, clinical research fellow, David Price, professor of primary care respiratory medicine, Stan D Musgrave, research fellow, Shweta Malhotra, research assistant, Amanda J Lee, professor of medical statistics, Dolapo Ayansina, research fellow, Aziz Sheikh, director of research, Lionel Tarassenko, professor of electrical engineering, director, Claudia Pagliari, senior lecturer, Hilary Pinnock, senior clinical research fellow. All of these professionals are experts in this subject matter and reliable for the information they are povinding.
Reflection: This source is valuable because it provides crucial information regarding the insignificance of mobile apps rcorrleating with asthma management and the minute magnitude of impact it has on drastically improving asthmatic care. The data from their trail has helped me understand that 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.
Annotated Bibliography 2:
Source #2: “Why Do Asthma Apps Only Capture Less than 1 Procent of the Market.”research2guidance, 5 Mar. 2019, research2guidance.com/why-do-asthma-apps-only-capture-less-than-1-of-the-addressable-market-top-10-asthma-apps/.
There are 300 million people in this world suffering from a chronic disease known as asthma. There many ways to manage it but only 1 percent utilize asthma apps in todays tech savvy era. Research2Guidance’s analysis of the 2017 mobile health apps that target primarily asthma patients shows that the asthma market is yet to experience its breakthrough. Given the current asthma apps little impact on the digital solutions market and no asthma app dominating the market, the asthma app publishers must rethink their business concepts and service offerings. Continued quality improvement of the asthma apps to meet best in class standards for better user acquisition and retention, in addition to further improvement of digital health innovation competencies to offer more original and personalized mHealth solutions in relation to prevention, diagnosis, and treatment of asthma sufferers will have a high impact on the market. The opportunity is there to be taken and to play a key role in improving the quality of asthma sufferers’ lives.
Quotes:
“No updates: 42% of the asthma apps belong to the longtail with zero downloads and updates in 2017”
“No behavior change support: Behavior change supporting features are especially helpful for COPD patients to self-manage their physical activity, starting with, for example, an exercise advice to help change patient’s attitude and behavior or follow up on their work /results in other apps”
“Seldom HCP support: Research HCP portals and license models are also hardly offered, excluding health insurance companies (HIC’s) and HCPs as distribution partners”
Assessment: This source is reliable because rearch2guidance research projects build upon their app market model that includes app market metrics such as downloads, revenues and monthly active users. Utilizing more than 200 data sources to support our forecasts and market evaluations, our reports provide the market insights that your company needs to succeed in today’s app economy. And with more than 80,000 contacts in our app ecosystem database we can quickly execute surveys to support your market research projects.
Reflection: This source is beneficial because it lists a good amount of reasons as to why mobile apps for asthma care is not reliable and effective.
Annotated Bibliography 3
Source #3 :Huckvale, Kit, et al. “Apps for Asthma Self-Management: a Systematic Assessment of Content and Tools.” BMC Medicine, BioMed Central, 22 Nov. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3523082/.
Apps have been enthusiastically adopted by the general public. They are increasingly recognized by policy-makers as a potential medium for supporting self-management of long-term conditions. The authors of the journals assessed the degree to which current smartphone and tablet apps for people with asthma offer content and tools of appropriate quality to support asthma self-management. They identified 103 apps for asthma in English, of which 56 were sources of information about the condition and 47 provided tools for the management of asthma. No apps offered both types of functionality. Only three information apps approached our definition of comprehensiveness of information about asthma. No apps provided advice on lay management of acute asthma that included details of appropriate reliever medication use. In 32 of 72 instances, apps made unequivocal recommendations about strategies for asthma control or prophylaxis that were unsupported by current evidence. Although 90% of apps stated a clear purpose, compliance with other best practice principles for health information was variable. Contact details were located for 55%, funding source for 18% and confidentiality policy for 17%.
Quotes:
“we were unable to identify the underlying calculation for most; numeric errors were present in those that we could verify and only one attempted to compensate for differences in readings from different peak flow meter types.”
“These findings have a number of consequences for clinicians, who may be considering using apps as part of routine asthma care. First, no current app can meet the needs of every patient. Instead, clinicians will need to draw from the diverse range of options. This requires that they themselves become familiar with a large number of apps, or that appropriate guidance is available to them.”
“. Possibilities include making app assessment part of the remit of guideline groups, requesting systematic reviews of content similar to this paper, self- or third-party accreditation, full regulation, usage studies and recommender systems. “
Assessment: This source is reliable since it is a government published journal which is written by several health professionals in this subject matter.
Reflection: This source is quite insightful because it provided valuable information regarding the efficiency of mobile apps on asthma care. It helped me come to the conclusion that no apps for people with asthma combined reliable, comprehensive information about the condition with supportive tools for self-management. Healthcare professionals considering recommending apps to patients as part of asthma self-management should exercise caution, recognizing that some apps like calculators may be unsafe; that no current app will meet the need of every patient; and that ways of working must be adapted if apps are to be introduced, supported and sustained in routine care. Policy-makers need to consider the potential role for assurance mechanisms in relation to apps. There remains much to be done if apps are to find broad use in clinical practice; clinicians cannot recommend tools that are inaccurate, unsafe or lack an evidence base.