‘They said it was bronchiolitis; is it going to turn into asthma doctor?’

Juan Carlos Ivancevich Tuesday, 26 August 2014 15:22
Cover image for Vol. 19 Issue 6
Dimos Gidaris, Don Urquhart and Michael B. Anthracopoulos

Beta-2 Adrenergic Receptor (ADRB2) Gene Polymorphisms and the Risk of Asthma: A Meta-Analysis of Case-Control Studies

Juan Carlos Ivancevich Wednesday, 20 August 2014 15:50
PLoS One. 2014; 9(8): e104488.
Published online Aug 11, 2014. doi:  10.1371/journal.pone.0104488
PMCID: PMC4128804

Operational definitions of asthma in recent epidemiological studies are inconsistent

Juan Carlos Ivancevich Saturday, 09 August 2014 18:37
Open Access

Ana Sá-SousaTiago JacintoLuís Filipe AzevedoMário Morais-AlmeidaCarlos Robalo-CordeiroAntónio Bugalho-AlmeidaJean Bousquet and João Almeida Fonseca

Gaining the Upper Hand on Pulmonary Drug Delivery

Juan Carlos Ivancevich Tuesday, 19 August 2014 13:52


Journal of Pharmacovigilance

Open Access
ISSN: 2329-6887

J Pharmacovigil. 2014 Mar 1;2(1):118.

Tyrrell J, Tarran R.

InSpire to Promote Lung Assessment in Youth: Evolving the Self-Management Paradigms of Young People With Asthma

Juan Carlos Ivancevich Wednesday, 06 August 2014 16:10

Original Paper

Pierre Elias1; Nithin O Rajan2, MBA; Kara McArthur3; Clifford C Dacso3,4, MBA, MPH, MD

1Duke University School of Medicine, Durham, NC, United States
2BSX Athletics, Houston, TX, United States
3The Abramson Center for the Future of Health, Houston, TX, United States
4Baylor College of Medicine, Houston, TX, United States

Corresponding Author:

Kara McArthur

The Abramson Center for the Future of Health
The Methodist Hospital Research Institute
6565 Fannin, MGJ 3012
Houston, TX, 77030
United States
Phone: 1 713 202 2462
Fax: 1 1 713 441 3554
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.


Background: Asthma is the most common chronic disease in childhood, disproportionately affecting urban, minority, and disadvantaged children. Individualized care plans supported by daily lung-function monitoring can reduce morbidity and mortality. However, despite 20 years of interventions to increase adherence, only 50% of US youth accurately follow their care plans, which leads to millions of preventable hospitalizations, emergency room visits, and sick days every year. We present a feasibility study of a novel, user-centered approach to increasing young people’s lung-function monitoring and asthma self-care. Promoting Lung Assessment in Youth (PLAY) helps young people become active managers of their asthma through the Web 2.0 principles of participation, cocreation, and information sharing. Specifically, PLAY combines an inexpensive, portable spirometer with the motivational power and convenience of mobile phones and virtual-community gaming.
Objective: The objective of this study was to develop and pilot test InSpire, a fully functional interface between a handheld spirometer and an interactive game and individualized asthma-care instant-messaging system housed on a mobile phone.
Methods: InSpire is an application for mobile smartphones that creates a compelling world in which youth collaborate with their physicians on managing their asthma. Drawing from design-theory on global timer mechanics and role playing, we incentivized completing spirometry maneuvers by making them an engaging part of a game young people would want to play. The data can be sent wirelessly to health specialists and return care recommendations to patients in real-time. By making it portable and similar to applications normally desired by the target demographic, InSpire is able to seamlessly incorporate asthma management into their lifestyle.
Results: We describe the development process of building and testing the InSpire prototype. To our knowledge, the prototype is a first-of-its kind mobile one-stop shop for asthma management. Feasibility testing in children aged 7 to 14 with asthma assessed likability of the graphical user interface as well as young people’s interest in our incentivizing system. Nearly 100% of children surveyed said they would play games like those in PLAY if they involved breathing into a spirometer. Two-thirds said they would prefer PLAY over the spirometer alone, whereas 1/3 would prefer having both. No children said they would prefer the spirometer over PLAY.
Conclusions: Previous efforts at home-monitoring of asthma in children have experienced rapid decline in adherence. An inexpensive monitoring technology combined with the computation, interactive communication, and display ability of a mobile phone is a promising approach to sustainable adherence to lung-function monitoring and care plans. An exciting game that redefines the way youth conduct health management by inviting them to collaborate in their health better can be an incentive and a catalyst for more far-reaching goals.

(Med 2.0 2013;2(1):e1)


pediatric asthma; chronic disease management; mobile phones; spirometry; gamification

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Editor: Juan C. Ivancevich, MD

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