Asynchronous digital health interventions for reviewing asthma: A mixed-methods systematic review protocol

PLOS ONE STUDY PROTOCOL Asynchronous digital health interventions for reviewing asthma: A mixed-methods systematic review protocol Md. Nazim Uzzaman ID1, Vicky Hammersley1, Kirstie McClatchey1, Jessica Sheringham2, G. M. Monsur Habib1,3, Hilary Pinnock ID1* a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, Scotland, United Kingdom, 2 Institute of Epidemiology & Health, University College London, London, England, United Kingdom, 3 Community Respiratory Centre, Bangladesh Primary Care Respiratory Society, Khulna, Bangladesh * Abstract Introduction OPEN ACCESS Citation: Uzzaman M.N, Hammersley V, McClatchey K, Sheringham J, Habib GMM, Pinnock H (2023) Asynchronous digital health interventions for reviewing asthma: A mixedmethods systematic review protocol. PLoS ONE 18(2): e0281538. https://doi.org/10.1371/journal. pone.0281538 Editor: Heather Leggett, The University of York, UNITED KINGDOM People living with asthma require regular reviews to address their concerns and questions, assess control, review medication, and support self-management. However, practical barriers to attending face-to-face consultations might limit routine reviews. Reviewing asthma using asynchronous digital health interventions could be convenient for patients and an efficient way of maintaining communication between patients and healthcare professionals and improving health outcomes. We, therefore, aim to conduct a mixed-methods systematic review to assess the effectiveness of reviewing asthma by asynchronous digital health interventions and explore the views of patients and healthcare professionals about the role of such interventions in delivering asthma care. Received: August 12, 2022 Accepted: January 25, 2023 Published: February 9, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0281538 Copyright: © 2023 Uzzaman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: No datasets were generated or analysed for this systematic review protocol. Summary tables and syntheses from the Methods We will search MEDLINE, Embase, Scopus, PsycInfo, CINAHL, and Cochrane Library from 2001 to present without imposing any language restrictions. We are interested in studies of asynchronous digital health interventions used either as a single intervention or contributing to mixed modes of review. Two review authors will independently screen titles and abstracts, and retrieve potentially relevant studies for full assessment against the eligibility criteria and extract data. Disagreements will be resolved by discussion with the review team. We will use ‘Downs and Black’ checklist, ‘Critical Appraisal Skills Programme’, and ‘Mixed Methods Appraisal Tool’ to assess methodological quality of quantitative, qualitative, and mixed-methods studies respectively. After synthesising quantitative (narrative synthesis) and qualitative (thematic synthesis) data separately, we will integrate them following methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Conclusion The findings of this review will provide insights into the role of asynchronous digital health interventions in the routine care of people living with asthma. PLOS ONE | https://doi.org/10.1371/journal.pone.0281538 February 9, 2023 1 / 14 PLOS ONE review will be made publicly available in a peerreviewed publication. Asynchronous digital health interventions for reviewing asthma Trial registration Systematic review registration: PROSPERO registration number: CRD42022344224. Funding: MNU is supported by a University of Edinburgh College of Medicine PhD Studentship (Grant number 34678) funded by the University of Edinburgh College of Medicine and Veterinary Medicine (CMVM) within the Asthma UK Centre for Applied Research (AUKCAR). The PhD studentship is nested in the IMP2ART (IMPlementing IMProved Asthma self-management as RouTine) programme at the University of Edinburgh (https://www.ed.ac. uk/usher/imp2art). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Introduction Asthma is a common, long-term airway disease affecting up to 18% of all age groups globally [1, 2]. Although, hospitalisation and deaths from asthma have declined in some countries, asthma continues to exert an unacceptably high burden on healthcare systems and society, resulting in reduced productivity at work and social disruption [2]. National and international guidelines recommend that people with asthma should be provided with self-management education reinforced by a personalised asthma action plan and supported by regular review to improve their control over their asthma [3–5]. An asthma review is a routine check-up of people with asthma to assess control, respond to that assessment by adjusting the management strategy, as well as to explore patients’ thoughts, concerns, and expectations, and to guide selfmanagement [6, 7]. Asthma reviews should be completed regularly (at least annually in stable patients) as a scheduled appointment [8]. A more frequent review may be necessary when a diagnosis is first made or for those who have poor asthma control [8]. However, across the United Kingdom (UK) National Health Service (NHS), 1 in 20 patients miss general practice (GP) appointments [9], and asthma clinics have higher than average proportion of missed appointments [10]. Practical barriers such as geographical distance, work commitments, transportation time and cost, long waiting time to attend face-to-face consultations may be barriers to regular reviews of asthma [11]. Digital health uses innovative information and communication technology to meet health demands. The term ‘digital health’ is an umbrella term encompassing eHealth, mHealth, health information technology, wearable devices, telehealth, telemedicine, and increasingly is linked with advanced computing such as machine learning and artificial intelligence [12, 13]. The World Health Organization (WHO) in 2005 urged member states to draw up a strategic plan for promotion of equitable, affordable and universal access to the benefits of digital health services [14]. In 2012, the European health policy framework-Health 2020 highlighted the importance of digital technology in advancing public health priorities and achieving the healthrelated Sustain (...truncated)