Abstract
BackgroundApps 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. We 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.MethodsWe adapted systematic review methodology to the assessment of apps. We identified English-language asthma apps for all ages through a systematic search of official app stores. We systematically assessed app content using criteria derived from international guidelines and systematic review of strategies for asthma self-management. We covered three domains: comprehensiveness of asthma information, consistency of advice with evidence and compliance with health information best practice principles.ResultsWe 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%.ConclusionsNo 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.
Highlights
Apps have been enthusiastically adopted by the general public
The UK Department of Health has suggested that apps be ‘prescribed’ as part of care for long-term conditions [4]. Proposals such as these motivate a question about whether current apps are suitable for this kind of use. We address this by focussing on apps for asthma as a representative long-term condition
Selection of apps We aimed to identify all apps for asthma accessible to English-speaking patients
Summary
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. Globally-relevant, managed substantially in primary care and amenable to self-management While both the content of asthma self-management education has been well described in UK [5], US [6] and international [7] evidence-based guidelines, and its positive impact on outcomes demonstrated [8], the best way to communicate information and support its use through tools is less clear. People with asthma are looking for alternatives; 65% report having used the internet to locate information about asthma without necessarily involving a health professional Taken together, these create a specific opportunity for new methods to support self-management education
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