Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study

Christopher J Licskai,Madonna Ferrone,Todd W Sands

doi:10.1155/2013/906710

Abstract

Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. To design, develop and pilot a mobile health system to support asthma self-management. The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smartphone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts. Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047). A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

Highlights

Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. obJeCTive: To design, develop and pilot a mobile health system to support asthma self-management
Asthma care based on guideline recommendations leads to well-controlled asthma in the majority of patients, studies have demonstrated that 50% of patients with asthma in Canada experience disease that is uncontrolled [1,5]
Collaborative self-management and engaging patients as active participants in their care can reduce this morbidity by 40% to 60% [7,8,9], is a key element in the Wagner chronic disease management model [10] and is a core recommendation of national asthma guidelines including the Canadian Asthma Consensus Guidelines (CACG)

Summary

Introduction

ConCLuSionS: A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels. An asthma action plan smartphone application (SPA) has the following advantages over a written action plan: decision support for the creation of an evidence-based plan; increased accessibility, portability 24 h per day, seven days per week; real-time and standardized assessment of asthma control with interactive feedback on clinical actions; automated medication adherence reminders; improved patient engagement and self-efficacy by capitalizing on teachable moments; and permitting real-time and forecast environmental inputs, such as air quality conditions, that support risk reduction/trigger avoidance behaviours.

Results

Conclusion