Impact of Technology-Based Interventions on Patient-Reported Outcomes in Asthma: A Systematic Review

Background Technology-based interventions (TBIs) can improve asthma management by facilitating patient education, symptom monitoring, environmental trigger control, comorbid condition management, and medication adherence. Collecting patient-reported outcomes (PROs) can identify effective interventions and ensure patient-centered care, but it is unclear which TBIs have been formally evaluated using PROs. Objectives We aim to: (1) identify the TBIs that have been evaluated in clinical trials using PROs; (2) identify the most commonly used PROs in these trials; and (3) determine the impact of TBIs on PROs in the management of chronic asthma. Methods We searched the PubMed and Clinicaltrials.gov databases for studies published in English between January 2000 and February 2020 using the following search criteria: "asthma," "IT-based interventions," "information technology," "technology," "dyspnea," "patient reported outcomes," "PROs," "telehealth," "telemedicine," and "mobile devices." Two independent reviewers screened the studies and determined study inclusion. Studies were examined for the types of interventions used, the types of PROs collected, and outcomes. Results The final analysis included 14 clinical trials with either 1, 2, or 3 arms. Five different types of TBIs were identified, most commonly involving multimedia education. Four different categories of PROs were identified, most commonly involving treatment self-efficacy. Positive outcomes in at least 1 PRO domain were reported in 12 of 14 studies. Pooled meta-analysis was not possible due to the heterogeneity of PRO instruments across studies. Conclusion TBIs improve PROs overall in patients with asthma. Future trials investigating TBIs should include standardized PROs as endpoints to better clarify this relationship. Technology-based interventions (TBIs) can improve asthma management by facilitating patient education, symptom monitoring, environmental trigger control, comorbid condition management, and medication adherence. Collecting patient-reported outcomes (PROs) can identify effective interventions and ensure patient-centered care, but it is unclear which TBIs have been formally evaluated using PROs. We aim to: (1) identify the TBIs that have been evaluated in clinical trials using PROs; (2) identify the most commonly used PROs in these trials; and (3) determine the impact of TBIs on PROs in the management of chronic asthma. We searched the PubMed and Clinicaltrials.gov databases for studies published in English between January 2000 and February 2020 using the following search criteria: "asthma," "IT-based interventions," "information technology," "technology," "dyspnea," "patient reported outcomes," "PROs," "telehealth," "telemedicine," and "mobile devices." Two independent reviewers screened the studies and determined study inclusion. Studies were examined for the types of interventions used, the types of PROs collected, and outcomes. The final analysis included 14 clinical trials with either 1, 2, or 3 arms. Five different types of TBIs were identified, most commonly involving multimedia education. Four different categories of PROs were identified, most commonly involving treatment self-efficacy. Positive outcomes in at least 1 PRO domain were reported in 12 of 14 studies. Pooled meta-analysis was not possible due to the heterogeneity of PRO instruments across studies. TBIs improve PROs overall in patients with asthma. Future trials investigating TBIs should include standardized PROs as endpoints to better clarify this relationship.