eHealth App Helps Self-Monitor Uncontrolled Asthma

Many patients with asthma remain symptomatic, despite medications and guidelines to manage the condition. More than half of individuals with asthma have poor medication adherence.

Digital solutions can help patients better manage the condition, leading to reduced symptoms and improved asthma.

An electronic health (eHealth) app, called AsthmaTurner, significantly improved the results of the Asthma Control Test, compared with conventional treatment, researchers found during a randomized controlled trial.

While researchers did not see a significant improvement in medication adherence, patients in primary care who used the app at least once a week saw an improvement.

“The system analyzes lung function and symptoms in accordance with asthma care guidelines,” said Björn Nordlund, Ph.D., Lung-Allergy Department at Astrid Lindgren Children’s Hospital, Karolinska University Hospital. “It then gives feedback in the form of automated, doctor-prescribed, treatment recommendation.”

Researchers at Karolinska Institutet in Sweden primarily sought to measure symptom control with the Asthma Control Test or Children Asthma Control Test at baseline and the end-visit in each treatment period. The research team also measured adherence with the Medical Adherence Report Scale based on how often participants forgot to take asthma medications.

Participants included children at least six years old and adults with a diagnosis of asthma and Asthma Control Test of Children Asthma Control Test scores below 20 points. Each participant was randomly assigned to the intervention group or had conventional treatment — non-digital self-management using paper treatment plans. The intervention lasted eight weeks.

AsthmaTurner is a cloud-based solution with a healthcare interface and downloadable patient app. The aim of the app was to distribute treatment plans to patients and improve self-management and education for patients.

Participants who use the app can register symptoms and measure forced expiratory volume in one second with a Bluetooth spirometer. The patient then get immediate feedback on the status of symptom control and a treatment recommendation.

The application gives patients and providers longitudinal data views of assessed symptom control, prescribed treatments and lung function measurements.

During their first visit, patients or caregivers completed a health questionnaire which included information on demographics, asthma, comorbidities and treatment.

In total, 77 of 90 participants completed the study, of which, 37 patients were from primary healthcare and 40 were children from a pediatric specialist.

Children who used AsthmaTurner showed significantly improved Children Asthma Control Test.

Medication adherence increased in 27 participants who used the app at least once a week.

“Thus, we conclude that this tool can contribute to alleviating uncontrolled asthma sufferers’ symptoms,” Nordlund concluded.

Future studies will assess AsthmaTurner in a bigger population with unselected symptom control. The research team will evaluate the effects on symptoms control and adherence and characterization of specific phenotypes based on lung function.

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