Can a smart app tame childhood asthma?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Observational study population: Inclusion Criteria: * Written informed assent or consent, and parental/caregivers consent, depending on age. * Age 10 to 19 years. * Sufficient understanding of the Romanian language. * Digital literacy, including the parents/caregivers, as assessed by the treating physician and/or by the recruiting healthcare provider using a multiple-choice questionnaire administered to the patient and their parents after a brief introduction to the functionalities of the Alex app. * Confirmed asthma, i.e., history of recurrent wheeze, at least one spirometry in the three years prior to inclusion showing reversible obstruction (increase in forced expiratory volume at one second (FEV1) of ≥12% and/or ≥200ml) and/or a positive airway challenge test142. * Participants need to be under treatment with regular prescribed asthma drugs, including inhaled corticosteroids, Long-acting β adrenoceptor agonists (LABA), and/or leukotriene receptor antagonists at recruitment, with no change in their medication in the last month. Exclusion Criteria: * Inability to perform adequate lung function measurements due to physical and/or intellectual disability. * Acute asthma exacerbation requiring systemic corticosteroids within four weeks prior to recruitment. * Not willing to use smartphones. * Underlying chronic respiratory disease other than asthma (cystic fibrosis, primary ciliary dyskinesia). * Acute lower respiratory tract infections (e.g., pneumonia, bronchitis) diagnosed by physician within past 4 to 6 weeks. For tuberculosis, see next exclusion criterion. * Active tuberculosis as per Quantiferon test. * Other causes of nocturnal cough such as postnasal drip, and vocal cord dysfunction. * Active smoking as per urinary Cotinin test. * Substance abuse as per urinary drug test. Qualitative study population: Inclusion criteria: * Enrolled in the observational study * Have had access to the DHA for at least 6 weeks * Provide informed assent (and parental/guardian consent where applicable) or consent, according to age * Able to participate in interviews or group discussions in Romanian Exclusion criteria: * Significant cognitive or communication difficulties that would limit participation in interviews or group discussions * Withdrawn from the observational study prior to data collection for qualitative work