Phone sex trials with no cc

Phone sex trials with no cc-34
All consenting participants were stratified by practice and centrally randomised (Health Services Research Unit, University of Aberdeen) to mobile phone or paper based monitoring with a 1:1 allocation with random block sizes of two or four; telephone randomisation ensured concealment until the treatment was assigned.

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Main outcome measures Changes in scores on asthma control questionnaire and self efficacy (knowledge, attitude, and self efficacy asthma questionnaire (KASE-AQ)) at six months after randomisation. The numbers of patients who had acute exacerbations, steroid courses, and unscheduled consultations were similar in both groups, with similar healthcare costs.

Overall, the mobile phone service was more expensive because of the expenses of telemonitoring. Globally, an estimated 300 million people have asthma, presenting a considerable and increasing burden of disease to healthcare systems, families, and patients.1 Despite two decades of asthma guidelines,2 asthma remains poorly controlled in a substantial proportion of people.3 Structured asthma management—which in the United Kingdom is predominantly delivered in primary care4—can improve outcomes in terms of exacerbations, admissions to hospital, and days lost from school and work.5 The concept of supported self management, engaging both clinicians and patients in delivering and implementing regular monitoring of control and adjustment of treatment, is a key recommendation of national and international guidelines.6 7 The theoretical model developed by Glasziou and colleagues, using asthma as an exemplar, describes the complementary and evolving roles of periodic support from professionals and ongoing self monitoring by patients.8 Our recent qualitative study suggests that people with asthma perceive a role for mobile technology in aiding transition from clinician supported phases while control is gained to effective self management during maintenance phases.9Poor adherence to monitoring and drugs is a potentially modifiable factor associated with poor control.10 In contrast with paper diary monitoring, in which as few as 6% of readings might be recorded,11 trials with electronic recording devices have shown rates of compliance of over 60%,12 especially if the patient is aware that their health behaviour is being observed.13 Timely feedback of results to the patient can objectively show severity of symptoms and the impact of compliance with drug treatment.

Conclusions Mobile technology does not improve asthma control or increase self efficacy compared with paper based monitoring when both groups received clinical care to guidelines standards. Mobile phones, the most pervasive and accessible form of technology globally,14 offer a highly convenient system for self monitoring coupled with instantaneous feedback, potentially engaging the patient in the monitoring and management of their asthma.

Set within the Medical Research Council’s framework for the design and evaluation of complex interventions,15 16 our phase III trial was underpinned by preliminary work that suggested that mobile phone based self monitoring of asthma care was feasible to deliver and acceptable to both patients and clinicians.9 12 17 We hypothesised that, in adolescents and adults with poorly controlled asthma offered treatment according to the British Thoracic Society/Scottish Intercollegiate Guideline Network (BTS-SIGN) asthma guideline,6 the use of mobile phone based monitoring of lung function and symptoms with feedback to patients would improve both control of asthma and patient self efficacy at six months compared with paper based monitoring strategies.

Design Multicentre randomised controlled trial with cost effectiveness analysis. Participants 288 adolescents and adults with poorly controlled asthma (asthma control questionnaire (ACQ) score ≥1.5) from 32 practices.

Intervention Participants were centrally randomised to twice daily recording and mobile phone based transmission of symptoms, drug use, and peak flow with immediate feedback prompting action according to an agreed plan or paper based monitoring. Results There was no significant difference in the change in asthma control or self efficacy between the two groups (ACQ: mean change 0.75 in mobile group −2.4, mean difference 2.0 (−0.3 to 4.2)).

One researcher (SDM or SM) prescreened respondents by telephone to determine whether they fulfilled the criterion of poorly controlled asthma and whether they had a contract with a compatible mobile phone network and a compatible handset.

Patients with an incompatible handset but who subscribed to a compatible network were offered the opportunity of borrowing a handset for the duration of the trial.

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