Summary of findings for the main comparison.
| Smartphone apps compared with paper‐based diaries for asthma self management | |||
|
Patient or population: patients with clinician‐diagnosed asthma Settings: primary and tertiary care Intervention: smartphone app for asthma self management Comparison: paper‐based diaries for asthma self management | |||
| Outcomes | Effects of smartphone apps for asthma self management | No of participants (studies) | Quality of the evidence (GRADE) |
|
Symptom scores Asthma Control Questionnaire (ACQ) ‐ 6‐item version Mean differences in scores at 6 months |
One study found no statistically significant difference in the mean difference in ACQ scores between the intervention and control group at 6 months (MD 0.01, 95% CI ‐0.23 to 0.25) | 278 participants (1 study) | ⊕⊕⊝⊝ low1 |
|
Patients with unscheduled visits to the emergency department 6‐month follow‐up |
One study found that participants in the intervention group were less likely to attend the emergency department than those in the control group (OR 0.20, 95% CI 0.04 to 0.99). Another study found no statistically significant difference between the intervention and control groups (Fisher's exact test P = 0.12) | 370 participants (2 studies) |
⊕⊕⊝⊝ low1 |
|
Hospital admissions 6‐month follow‐up |
None of the included studies found a statistically significant difference between the intervention and control groups (Fisher's exact test yielding a one‐sided P = 0.52; OR 3.07 (95% CI 0.32 to 29.83)) | 370 participants (2 studies) | ⊕⊕⊝⊝ low1 |
|
GP consultations for asthma 6‐month follow‐up |
One study did not find a statistically significant difference between the intervention and control groups (OR 1.40, 95% CI 0.85 to 2.31) | 281 participants (1 study) |
⊕⊕⊝⊝ low1 |
|
Unscheduled general practice nurse consultation 6‐month follow‐up |
One study found that participants in the intervention group were less likely to attend unscheduled general practice nurse consultations than those in the control group (OR 0.60, 95% CI 0.37 to 0.98) | 281 participants (1 study) | ⊕⊕⊝⊝ low1 |
|
Out of hours attendances 6‐month follow‐up |
One study did not find a statistically significant difference between the intervention and control groups (OR 0.60, 95% CI 0.14 to 2.54) | 281 participants (1 study) | ⊕⊕⊝⊝ low1 |
|
HRQoL measured on the SF‐12 questionnaire ‐ SF ‐ 12 6‐month follow‐up |
One study found that participants in the intervention group had significantly higher scores in both the mental and physical components of the SF‐12 questionnaire than those in the control group (MD 6.00, 95% CI 2.51 to 9.49 and MD 5.50, 95% CI 1.48 to 9.52, respectively) | 89 participants (1 study) |
⊕⊕⊝⊝ low1 |
|
HRQoL measured on the mini‐AQLQ 6‐month follow‐up |
One study did not find a statistically significant difference between the intervention and control groups in their mean scores on the mini‐AQLQ (MD 0.02, 95% CI ‐0.35 to 0.39) | 201 participants (1 study) |
⊕⊕⊝⊝ low1 |
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. AQLQ: Asthma Quality of Life Questionnaire; CI: confidence interval; HRQoL: health‐related quality of life; MD: mean difference; OR: odds ratio | |||
1All outcomes were graded as low quality because further evidence is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. The two included studies were clinically heterogeneous and their results were therefore not combined. We also took into consideration the high/unclear risk of bias in our assessment of the quality of the evidence.