***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective To determine whether mobile phone based monitoring improves asthma control compared with st and ard paper based monitoring strategies . Design Multicentre r and omised controlled trial with cost effectiveness analysis . Setting UK primary care . Participants 288 adolescents and adults with poorly controlled asthma ( asthma control question naire ( ACQ ) score ≥1.5 ) from 32 practice s. Intervention Participants were central ly r and omised 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 . Main outcome measures Changes in scores on asthma control question naire and self efficacy ( knowledge , attitude , and self efficacy asthma question naire ( KASE-AQ ) ) at six months after r and omisation . Assessment of outcomes was blinded . Analysis was on an intention to treat basis . 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 v 0.73 in paper group , mean difference in change −0.02 ( 95 % confidence interval −0.23 to 0.19 ) ; KASE-AQ score : mean change −4.4 v −2.4 , mean difference 2.0 ( −0.3 to 4.2 ) ) . 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 . 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 st and ards . The mobile technology was not cost effective . Trial registration Clinical Trials NCT00512837 AIMS There is increasing international interest in using emerging technologies to enhance chronic disease management . We aim ed to explore the attitudes of patients and primary care professionals to using mobile technology in order to monitor asthma . METHODS A piloted question naire containing closed and open-ended questions assessing attitudes to using electronic self-monitoring was posted to a r and om sample of general practitioners , asthma nurses , and people with asthma ( 12 years and over ) in Lothian and Kent , UK , with 2 reminders . In addition to descriptive statistics , patient and clinician responses were compared using Chi-squared or independent sample t-tests . Free-text responses were analysed thematically . RESULTS Responses were obtained from 130/300 professionals ( 43 % ) and 202/389 patients ( 52 % ) . Patients rated the technology positively and considered that it may help clinicians to provide care , especially during acute attacks . Although rated similarly , professionals were more sceptical about benefits . Both professionals and patients had concerns about the time and cost implication s. Of the respondents , 28 professionals ( 10 % ) and 62 patients ( 16 % ) returned uncompleted question naires citing lack of perceived relevance . CONCLUSIONS The low completion rate probably reflects the current status of mobile phone-facilitated care as a minority interest for ' early adopters ' of technology . Even for the enthusiastic minority , using mobile phone technology raised questions of clinical benefit , impact on self-management , and concerns about workload and cost , which will need to be addressed prior to wider acceptance The self-management of asthma can improve clinical outcomes . Recently , mobile telephones have been widely used as an efficient , instant personal communication tool . This study investigated whether a self-care system will achieve better asthma control through a mobile telephone-based interactive programme . This was a prospect i ve , controlled study in outpatient clinics . From 120 consecutive patients with moderate-to-severe persistent asthma , 89 were eventually recruited for the study , with 43 in the mobile telephone group ( with a mobile telephone-based interactive asthma self-care system )  . In the mobile telephone group , mean±sem peak expiratory flow rate significantly increased at 4 ( 378.2±9.3 L·min−1 ; n = 43 ; p = 0.020 ) , 5 ( 378.2±9.2 L·min−1 ; n = 43 ; p = 0.008 ) and 6 months ( 382.7±8.6 L·min−1 ; n = 43 ; p = 0.001 ) compared to the control group . Mean±sem forced expiratory volume in 1 s significantly increased at 6 months ( 65.2±3.2 % predicted ; n = 43 ; p<0.05 ) . Patients in the mobile telephone group had better quality of life after 3 months , as determined using the Short Form-12 ® physical component score , and fewer episodes of exacerbation and unscheduled visits than the control group . Patients in the mobile telephone group significantly increased their mean daily dose of either systemic or inhaled corticosteroids compared with the control group . The mobile telephone-based interactive self-care system provides a convenient and practical self-monitoring and -management of asthma , and improves asthma control Objectives : To determine whether well trained lay people could deliver asthma self-management education with comparable outcomes to that achieved by primary care based practice nurses . Design : R and omised equivalence trial . Setting : 39 general practice s in West London and North West Engl and . Participants : 567 patients with asthma who were on regular maintenance therapy . 15 lay educators were recruited and trained to deliver asthma self-management education . Intervention : An initial consultation of up to 45 min offered either by a lay educator or a practice based primary care nurse , followed by a second shorter face to face consultation and telephone follow-up for 1 year . Main outcome measures : Unscheduled need for healthcare . Secondary outcome measures : Patient satisfaction and need for courses of oral steroids . Results : 567 patients were r and omised to care by a nurse ( n = 287 ) or a lay educator ( n = 280 ) and 146 and 171 , respectively , attended the first face to face educational session . During the first two consultations , management changes were made in 35/146 patients seen by a practice nurse ( 24.0 % ) and in 56/171 patients ( 32.7 % ) seen by a lay educator . For 418/567 patients ( 73.7 % ) , we have 1 year data on use of unscheduled healthcare . Under an intention to treat approach , 61/205 patients ( 29.8 % ) in the nurse led group required unscheduled care compared with 65/213 ( 30.5 % ) in the lay led group ( 90 % CI for difference −8.1 % to 6.6 % ; 95 % CI for difference −9.5 % to 8.0 % ) . The 90 % CI contained the predetermined equivalence region ( −5 % to + 5 % ) giving an inconclusive result regarding the equivalence of the two approaches . Despite the fact that all patients had been prescribed regular maintenance therapy , 122/418 patients ( 29.2 % ) required courses of steroid tablets during the course of 1 year . Patient satisfaction following the initial face to face consultation was similar in both groups . Conclusions : It is possible to recruit and train lay educators to deliver a discrete area of respiratory care , with comparable outcomes to those seen by nurses . Trial registration number : AIM To evaluate patient underst and ing of their asthma and determine patient preferences regarding the delivery of asthma care and treatment . METHODS Adults with asthma receiving treatment for mild to moderate asthma were recruited to a two-part study : a qualitative phase using a semi-structured interview schedule followed by a quantitative phase based on a structured interview schedule . All interviews were undertaken face-to-face . SETTING AND SUBJECTS A r and om sample of 40 patients with mild to moderate asthma from seven areas of the UK took part in the qualitative phase of the study . In the quantitative phase , 517 patients on treatment for mild to moderate asthma were interviewed in person by market research ers . This population was achieved using a quota sampling approach that also achieved a representative demographic profile . Initial contact was made in door-to-door calls . Interviews took place in 64 locations across the UK . RESULTS Ninety-one percent ( n=468 ) of respondents felt their asthma was under control , yet two-thirds ( n=339 ) experienced symptoms at least 2 - 3 times a week . Only 24 % ( n=123 ) felt their asthma could improve over time , and 71 % ( n=366 ) received no advice from healthcare professionals on how their asthma might change in the future . Fourteen percent ( n=74 ) of respondents had no ongoing contact with any healthcare professional regarding their asthma . Fifty-eight percent ( n=301 ) were very satisfied with their asthma care , but this dropped to 33 % ( n=173 ) when respondents were shown asthma guidelines regarding what to expect from treatment . Sixty-two percent ( n=318 ) of respondents said their asthma varied at different times of the day , and 86 % ( n=444 ) stated that their asthma varied at different times of the year . Eighty percent ( n=414 ) of respondents had never been provided with a written , personal asthma action plan recommending changes patients could make themselves to prescribed treatment according to symptom severity , though 68 % ( n=353 ) said they would feel comfortable following such a plan . CONCLUSIONS Most patients have low expectations of what can be achieved by asthma management and do not realise their condition can be improved . Many are resigned to the effects of poor asthma control until made aware that guidelines indicate this can be better . Given that many are receptive to the notion of written , personal asthma action plans , the implementation of these , supported by appropriate education , could help patients achieve improved asthma control BACKGROUND Adherence to medication regimens is poor in the management of chronic diseases , including asthma . OBJECTIVE To determine whether an audiovisual reminder device improves adherence with inhaled corticosteroid ( ICS ) therapy in adult asthma . METHODS A r and omized open-label parallel group study of 110 adult or adolescent subjects with asthma was undertaken . Subjects were r and omized to receive 24 weeks of fluticasone propionate 250 microg , 1 actuation twice daily via a metered dose inhaler ( MDI ) with or without an audiovisual reminder function ( AVRF ) . All MDIs had electronic covert adherence monitors . The primary outcome variable was adherence , defined as the proportion of medication taken as prescribed over the final 12 weeks of the study . Adherence was also assessed as the proportion of subjects who took > 50 % , > 80 % , or > 90 % of prescribed medication . RESULTS The proportion of medication taken in the last 12 weeks was greater in the AVRF group ( 93 % ) compared with the control group ( 74 % ) , with a difference of 18 % ( 95 % confidence interval [ CI ] 10 - 26 % ; P < .0001 ) . The proportion of subjects taking > 50 % , > 80 % , or > 90 % of their medication was greater in the AVRF group , with a ratio of proportions adherent of 1.33 ( 95 % CI , 1.10 - 1.61 ; P = .003 ) , 2.27 ( 95 % CI , 1.56 - 3.3 ; P < .0001 ) , and 3.25 ( 95 % CI , 1.74 - 6.1 % ; P < .0001 ) , respectively . CONCLUSION An audiovisual reminder function can significantly improve adherence with ICS therapy in adult asthma . CLINICAL IMPLICATION S An audiovisual reminder function has potential to improve adherence with medication regimens across a wide spectrum of diseases , in both research and clinical practice Objective . To evaluate the impact of peak flow or symptom-based self – management plans on asthma control and patients ' quality of life and to determine the main psychosocial factors that affect compliance with these plans . Methods . The study sample consisted of 63 patients with persistent asthma out patients . Data collection included demographics , pulmonary functions , symptom scores , and asthma control parameters recorded over the previous 2 consecutive years . A st and ard asthma self-management education program including personal action plans was given to the patients who were r and omly divided into peak flow meter ( PFM ) ( n = 31 ) or symptom-based ( n = 32 ) action plan groups . Patients were then assessed prospect ively for various study outcomes including symptoms , drug compliance , psychiatric co-morbidities , quality of life , and asthma control over the next 12 months . Psychiatric co-morbidities were assessed using Rotter 's Internal and External Locus of Control Scale ( RIELCS ) , Beck Depression Inventory ( BDI ) , Structured Clinical Interview for DSM-IV ( SCID-I ) , Spielberger State-Trait-Anxiety Inventory ( STAI ) , and Short Form-36 ( SF-36 ) . Results . Of the 63 patients ( 79 % female ; mean age 43 ) , 85 % of them had moderately or severely persistent asthma .  Baseline demographics , clinical parameters , psychiatric diagnosis , and quality of life were not different between groups . Personal asthma plans increased optimal asthma control significantly . Emergency visits , antibiotic treatments , systemic corticosteroid treatments , and unscheduled visits were fewer than the previous year . Control parameters were better in the PFM group . After the self-management education , the quality of life dimensions , i.e. , vitality , total mental and general scores of both groups increased . Frequency of psychiatric co- 
    Output:
    
Both studies failed to find any statistical differences in terms of adherence to the intervention and occurrence of other asthma-related complications .