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Randomized Controlled Trial
. 2024 Oct 25;50(1):220.
doi: 10.1186/s13052-024-01792-w.

A smartphone app for preschool wheezing and reliability of medical history collection

Nicola Ullmann  1 , Adriana Fracchiolla  2 , Alessandra Boni  2 , Valentina Negro  2 , Federica Porcaro  2 , Antonio Di Marco  2 , Salvatore Tripodi  3 , Renato Cutrera  2
Affiliations
Randomized Controlled Trial

A smartphone app for preschool wheezing and reliability of medical history collection

Nicola Ullmann et al. Ital J Pediatr. .

Abstract

Background: The use of mobile applications helps improving self-management in adolescents with asthma. However, no evidence is available for children with preschool wheezing. In addition, we have no data on the reliability of medical history collected at visits. The first aim was to assess the feasibility of a smartphone app in the management of preschool wheezing; secondly we aimed to evaluate the reliability of anamnestic data collected during face-to-face medical interviews.

Methods: Children with recurrent wheezing, age between 25 and 72 months, were randomly assigned to the intervention group, provided with a smartphone app for symptoms monitoring and asthma attack treatment, or to the control group, with a written action plan. At follow-up medical history was collected and the asthma control test and a clinical questionnaire were completed. App acceptability was also explored. Respiratory symptoms, medication and utilization of healthcare resources were collected. Plus, medical information obtained from the paper questionnaires was compared with data daily recorded by the app.

Results: We enrolled 85 preschool children with recurrent wheezing: 43 assigned to the intervention and 42 to the control group. The average (SD) adherence to e-Diary compilation was 60 (15)%. The acceptance and usability of the intervention was favorable as 70% and 93% of participants in the intervention arm described the app as ''simple and intuitive'' at Visit1 (after 3 months from enrollement) and Visit2 (3 months later than Visit1), respectively and 95% and 98% found it useful in symptoms management. There were no significant differences between the two groups in clinical outcomes. At Visit1, the cACT median score (IQR) was 23,5 (21-25) for the control group (42 patients) and 23 (21-24) for the intervention group (43 patients). At Visit2 (41 controls and 42 in the intervention group) it was 25 (24-25) and 24 (24-25), respectively. Secondary analysis of data from the intervention group showed higher incidence of daily symptoms recorded by the app in comparison with the paper questionnaire, suggesting that collection of retrospective medical history may not be completely reliable.

Conclusions: The smartphone app is usable and acceptable by families of preschool wheezers. Future controlled trial are needed to prove an impact on clinical outcomes or its efficacy in a telemedicine program. Finally a daily questionnaire could provide physicians with a more reliable clinical picture as reflected better daily asthma symptoms than the written retrospective questionnaire filled at clinical visit.

Keywords: Application; Children; Medical history; Mobile; Preschool; Reliable; Smartphone; Wheezing.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The study design. Legend: Details of the study design: recruitment, randomization and follow-up. Abbreviations: App (Smartphone Application); cACT (Children Asthma Control Test); CQ (Clinical Questionnaire)
Fig. 2
Fig. 2
Screenshots of the App (Asmapp). Top left square: login steps; center top square: indicates different options for users (complete your diary, see your scores, asthma exacerbation, tutorial, preferences, logout); top right square: daily diary (did you have fever or cold?); bottom left square: other questions of the daily diary (did you have daily cough, night cough, wheeze, difficult breathing, symptoms that affected daily activities?); bottom middle square (did you need salbutamol?), bottom right square: thanks for completing your diary
See this image and copyright information in PMC

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