Summer reading: Are mobile asthma management tools effective?

By: Brian Dolan | Jul 24, 2012        

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AsthmapolisA recent must-read report from the New England Health Institute (NEHI) identified about a dozen different promising digital health technology trends and offered up an analysis of the market readiness of each. Central to NEHI’s determination of how evolved a particular digital health technology was, rested on its efficacy evidence base. The report is actually organized into sections that group the technologies into four separate “classes” – from “Class I” technologies that already have significant evidence base and fewer barriers to entry to “Class IV” technologies which have next to no evidence base yet but still point to promising ideas.

Mobile asthma management tools fell somewhere in the middle of the spectrum for market readiness based on evidence base. As a “Class III” technology, mobile asthma management tools “leverage well- established clinical interventions recognized in the literature to have clinical or financial benefit,” according to NEHI, but they also have “limited evidence to support the technology itself having clinical or financial benefit.” These technologies also “only [have] a transitive link between the clinical intervention and the technology itself.”

NEHI describes the state of mobile asthma management offerings as GPS attachments to inhalers, mobile tracking manual entry apps, and early warning software for asthma triggers. NEHI specifically points to Asthmapolis, which just received FDA clearance for its GPS-enabled device, as well as AsthmaSense and Asthma Signals in its report.

The institute also included a fairly comprehensive roundup of efficacy studies that have leveraged mobile of digital asthma management tools, here’s the summary from NEHI:

  • A five month study in 2010 focused on rural adults with asthma in 12 states and showed that many of them were able to get their symptoms under control after being given baseline data collected from a rescue inhaler with a GPS attachment (n=42).
  • Another study in 2009, looking at the same tool over a four-month period with a different population, showed that 75 percent of the patients improved their level of asthma control to some degree (n=40).
  • A 2007 study examined the effectiveness of audiovisual reminders in promoting adherence to inhaler therapy and demonstrated positive results, with 95.5% of patients who received reminders taking more than half of their prescribed medication compared to only 71.7 percent for patients not receiving reminders. (n=110).
  • Some asthma demonstration projects have shown that about 90 percent of attacks experienced by children with poor control of their asthma can be eliminated with appropriate information and action.14 Other mobile asthma management tools have shown promising anecdotal evidence regarding clinical outcomes, but published results were not available.
  • One asthma management tool has tracked over 50,000 users and improved the health of some asthmatics, though a randomized trial has not been conducted.

Mobile asthma management tools face many of the same barriers to market that all digital health services are dealing with: Ease of use issues, especially among the elderly or the less technology savvy; few services have proven ROI or health outcomes; GPS-enabled tracking especially will raise privacy issues for some; smartphone devices are sometimes cost-prohibitive for certain groups; insurance companies do not cover these programs, and patients are unlikely to purchase them out-of-pocket, NEHI wrote.

Read the full NEHI report here.