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Smartphone Applications and Snap-On Sensors Help Improve Care of People with Asthma

Asthmapolis today announced an investigation featuring the system in the remote monitoring of inhaled bronchodilator use and weekly feedback about asthma management has been published in the latest issue of the scientific journal PLOS ONE.

The study found improved asthma control and a decline in day-to-day asthma symptoms for participants receiving Asthmapolis' weekly email reports and online charts summarizing inhaler use and location.

First author on the report is David Van Sickle , PhD, CEO and Asthmapolis co-founder, with contributors Sheryl Magzamen , PhD, MPH, and Shaun Truelove , MPH, from the University of Wisconsin-Madison School of Medicine and Public Health, Department of Population Health Sciences, and Teresa Morrison , MD, MPH, from the Centers for Disease Control and Prevention, National Center for Environmental Health, Air Pollution and Respiratory Health Branch in Atlanta.

Asthmapolis is an FDA-cleared mobile health solution designed to improve the care of people with asthma, advance understanding of symptoms and triggers and help them achieve control of the disease. Asthmapolis uses a novel combination of smartphone applications and snap-on sensors that track when and how often patients use their inhaled medications. The platform, available in both English and Spanish, is designed to help individuals stick with their daily preventive medications, reveal insights about their use of rescue medications and provide personalized feedback, targeted education and other tools that improve their ability to successfully manage the disease.

Through this open-group short-term pilot study, the researchers sought to determine whether weekly email reports on monitored use of inhaled, short-acting bronchodilators might improve scores on composite measures of asthma control.

The team monitored inhaler use for four months using the Asthmapolis system, and participants completed periodic surveys, including the Asthma Control Test™ (ACT) to assess changes in asthma control. After the first month, participants received weekly email reports for the remainder of the study period that summarized their inhaler use during the preceding week and provided self-management suggestions derived from National Asthma Education and Prevention Program guidelines.

No significant changes in asthma control appeared during the first month, however, after participants began receiving email reports and online information about their inhaler use, mean ACT scores increased 1.40 points for each subsequent month in the study. At the conclusion of the study period, 75% of participants had controlled asthma (by ACT score) compared with 38% at entry.

Participants reported increased awareness and understanding of patterns with their asthma, including the time and location of inhaler use, their asthma triggers, level of control and the importance of adherence to preventive practices.

"I learned that I used my inhaler more than I remember. I was able to see and relate to my doctor that my asthma is not under control," one participant described.

Study participants also reported knowing the time and location where they used their inhaler helped to highlight locations and exposures to triggers that led to symptoms. "I've been more keen to note surroundings when I feel shortness of breath," one participant said. "It opened my eyes to triggers I wasn't aware of in the past."

Weekly feedback also helped to reinforce participant use of controller medications, and the majority expressed an interest in continuing to track their inhaler use. "I'm now using my controller medicine more regularly and on time," said another participant. "I noticed that my rescue inhaler use went down significantly when using a daily inhaler as well."

"Today, many patients have inappropriately low expectations for their own disease control or are unaware that more can be done to prevent attacks and day-to-day symptoms. Others fail to voice concerns or to report troublesome symptoms," said Van Sickle . "This study has demonstrated that simple interventions that use objectively collected data from daily life can make self-management more compelling, play a valuable role in developing and reinforcing better habits and provide patients with valuable information to help guide management and achieve control of their disease."

Paper: Remote monitoring of inhaled bronchodilator use and weekly feedback about asthma management: An open-group, short-term pilot study of the impact on asthma control, by David Van Sickle , PhD, Sheryl Magzamen , PhD, MPH, Shaun Truelove , MPH, Teresa Morrison , MD, MPH, PLOS ONE, 28 February 2013.

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