Real-time symptom monitoring of dyspnea via ecological momentary assessment

Background: Dyspnea is an overwhelmingly unpleasant sensation associated with qualitative descriptors such as "suffocation," "choking," and "drowning."Like all memory recall, retrospective dyspnea symptom reports are subject to bias and may be influenced by affective components. However, real-time symptom monitoring is more accurately reflective of physiological airway changes. Evidence of real-time dyspnea symptom tracking using ecological momentary assessment (EMA) via smartphone technology is limited. The aim of this pilot study was to assess the feasibility, acceptability, and utility of a technology-enabled symptom monitoring intervention in individuals with chronic respiratory disease (including chronic obstructive pulmonary disease and asthma). Methods: An iterative design process was used by a multidisciplinary team (physicians, nurses, respiratory therapists, and respiratory psychophysiologist) to develop the Smartphone Airway Monitoring System (SAMS). A cross-sectional repeated measures design was used to evaluate EMA combined with Bluetooth-enabled inhalers for real-time smartphone monitoring (n=20). Results: Smartphone real-time respiratory symptom tracking is acceptable and feasible in adults and children with chronic respiratory disease. The majority of patients own a smartphone, but new/replacement smartphones loans are needed for some patients. Discussion: An mHealth platform (SAMS) enabled real time symptom assessment in the home environment. An iterative design enhanced engagement. Ongoing investigations focus on the accuracy of symptom perception, self-efficacy, momentary factors that impact adherence behaviors and effective monitoring approaches in both pediatric and adult populations.