ABSTRACT
Background: The treatment with controller medication, regular monitoring of symptoms and lung function is required for achieving and maintenance of asthma control in children. The telemedicine technologies using have benefits for distance monitoring, especially during the COVID-19 pandemic. The aim of the study was to analyze the efficacy of our developed mobile technology called MedQuizBot, to evaluate the patient adherence and satisfaction with it. Method: The 6 month prospective observation study of 68 children with asthma (4 to 17 ages) was conducted. All patients were offered to use MedQuizBot via Telegram messenger. Patients had to enter their peak expiratory flow (PEF) values daily and complete asthma control tests (ACT) monthly from March to September 2020 year. MedQuizBot sent notifications to enter data. All patients were able to send e-messages to the doctor via Telegram. Results: 41 patients agreed to use MedQuizBot for the asthma symptoms monitoring. Poor adherence to data entry was mostly detected: ACT was completed 1.5 times, CACT-1.8 times in average. Uncontrolled asthma was observed 7 times more often in children >12 y.o. (27%), than in children under 12 y.o (4%). PEF values were entered by 21 patients (51%). Patients <12 y.o., who completed the test with the parents, entered data 7 times more often, than adolescents. 70% of patients had good asthma control. The data were entered 2.5 times more often during the lockdown in Moscow, caused by COVID-19 pandemic and high tree pollen season in spring compared to summer 2020 (609 and 263 interactions, respectively). 5 patients (12%) sent questions to the doctor about their symptoms (cough, shortness of breath, nasal congestion or sneezing) and received the answers with recommendations. Most patients (92%) noted the satisfaction with MedQuizBot using, its effectiveness in achieving asthma control and would agree to use it again. Conclusion: Among various telemedicine technologies, the use of messengers for monitoring asthma patients seems to be the most effective. MedQuizBot was effective in achieving asthma control and is especially needed for monitoring the patients with insufficient disease control, during pollen allergens exposure, acute respiratory diseases, pandemic, poor access to health care.
ABSTRACT
Background. Anti-inflammatory therapy is used to achieve and maintain asthma control, as well as respiratory function indicators monitoring. Telemedicine technologies can be used for this purpose, and it became particularly essential during the COVID-19 pandemic. Objective. The aim of the study is to analyze efficacy of the mobile technology MedQuizBot for asthma monitoring, to estimate patient compliance to use such instruments of self-control via the bot and without it, and bot's functioning satisfaction. Methods. 6-month prospective observational comparative study in patients with asthma from 4 to 17 years old was conducted. All patients were divided into two groups: patients who have used MedQuizBot and patients who have used any other self-control tools. Patients had to enter peakflowmetry data daily and undergo asthma control tests monthly. Patients were able to communicate with their doctor remotely via the chat bot. Main study indicators: determining the efficacy of MedQuizBot in patients with asthma by estimating the compliance to self-control tools at using the bot. Secondary study indicators: estimation of patients satisfaction on using the MedQuizBot and determination of level of asthma control due to the obtained data results. Results. 41 patients have used MedQuizBot, 27 patients were in the control group. Patients who used the bot more often answered asthma control test questions. Patients over 12 years old have completed the asthma control test less often than young children: ACT was filled on average in 1.5 times, САСТ — 1.8 times. 51% of patients filled in data on peakflowmetry via the new technology, patients from control group did not start the picflowmetry diary. Patients under 12 years old, who filled up the test with their parents, has entered picflowmetry data 7 times more often than adolescents. The asthma was under control in 70% of patients. The data was entered into the system 2.5 times more often during the lockdown period due to COVID-19 pandemic and during the tree flowering season in comparison to other periods of 2020. Patients noted the usability of the MedQuizBot and agreed to use it in future. Conclusion. MedQuizBot is effective in achieving asthma control mainly during the period of need — in case of insufficient control over the disease itself (exposure to pollen allergens, acute respiratory diseases), during the limitations in medical care availability.