Digital Drug Monitoring Cuts Hospitalizations for Patients with Asthma

Increased monitoring of medication use by patients with asthma could lead to dramatically lower hospital utilization, a new study finds.

Researchers say patients who used a digital asthma monitoring system had 54 percent fewer asthma-related emergency department visits in the year following the program’s launch and 57 percent fewer events requiring either an emergency department visit or a hospital stay.

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“We are excited about the results, which further affirm the power digital tools provide in empowering patients to better manage their condition,” said Rajan Merchant, M.D., of Dignity Health, in a press release. Merchant is the lead author of the study. Dignity Health is a San Francisco-based health system.

The study involved 224 patients with asthma who received medical care at Dignity Health’s facilities. To qualify, patients needed to have an asthma diagnosis, a prescription for a short-acting beta agonist and no other pulmonary disease or significant comorbidities. The patients received Propeller Health’s electronic medication monitors, which attach to asthma medications and track frequency of use and number of puffs.

Data generated by the monitors were made available to patients and providers.

The study compared hospital usage for the year before monitoring began to the year after initiation of monitoring.

Over the year of monitoring, asthma-related emergency department visits dropped from 11.6 to 5.4 visits per 100 patient years. Combined, hospitalizations and emergency department visits dropped from 13.4 to 5.8 visits per 100 patient years.

The study’s authors concluded that it is feasible to incorporate the monitoring system into routine asthma care, and that doing so promotes better patient self-management and better decision-making by patients and their doctors.

Propeller Health’s Rahul Gondalia, MPH, a study co-author, told Healthcare Analytics News™ that the availability of data to help facilitate physician-patient conversations is particularly important.

“While real-time monitoring of medication use likely caused patients to be more vigilant and compliant to their medications, the improved patient-provider communications coupled with real-time, objective medication use data likely played a larger role,” he said.

Gondalia said he does not have sufficient data to determine which specific interventions seemed to have the most impact. But the technology seems to have the greatest effects when used by physicians to inform care.

“In other studies, we observed that use of the digital health intervention without (healthcare provider) involvement was associated with improved clinical outcomes, but the improvements are larger when there is healthcare provider involvement,” he said.

Indeed, while hospitalizations and emergency department visits both dropped, outpatient visits increased by 2.6 visits per patient year, indicating that patients handled emerging issues before they became severe enough to warrant hospitalization.

“Patients and providers could be more aware of their status and more proactive in their management,” Gondalia said. “However, this study was not designed to assess the impact of healthcare providers specifically.”

The study is titled “Impact of a digital health intervention on asthma resource utilization.” It was published Dec. 3 in the World Allergy Organization Journal.

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