Asthma Mobile Applications to Improve Self-Management

More than 17 million cases of adult asthma were reported in the United States in 2015, with an estimated 50% having poorly controlled asthma. Non-adherence to evidence-based guidelines for self-management is strongly correlated to poor control. Appropriate utilization of good self-management skills through an individualized asthma action plan (AAP) has been shown to improve patient outcomes, but mounting evidence indicates AAPs are underutilized. Adult patients can face many barriers to utilizing their AAP, such as unfamiliarity with how to use the plan and forgetting to take their medications. Patients may also be unaware of symptom trends and peak flow changes, which can lead to exacerbations. Patients can have difficulty recalling the frequency and duration of asthmatic exacerbations, night awakenings, and level of limited activity with exacerbations. Accurate recall of asthma exacerbations is vital, but can also be challenging for patients. Finding solutions to overcome the barriers of using the AAP is essential. Mobile applications, also referred to as apps (e.g., smartphone, web-based apps), are a relatively new technology that is showing potential to improve management of long-term illnesses. Asthma mobile apps are a potentially effective tool to facilitate use of an AAP for good self-management. However, there are multiple asthma mobile apps, and minimal research has been undertaken to narrow the selection to evidence-based content apps that are patient-preferred. Identifying patient-preferred, evidence-based content apps will help health care providers confidently recommend an appropriate app that patients are more likely to use for improved self-management. The purpose of this project was to identify apps with evidence-based content and evaluate the perceived benefits associated with using an asthma mobile app for self-management. The findings of this project will help health care providers confidently recommend patients an available app with the most benefits and appreciable ease of use, to facilitate use of their individualized AAPs. The project objectives included (a) identification of appropriate asthma mobile apps that have evidence-based content to facilitate use of the asthma action plan in patients >18 years; (b) education of patients with asthma regarding the potential benefits of using each selected asthma mobile app to facilitate self-management; (c) assessment and evaluation of patient-perceived benefits through a post-questionnaire to determine perceived app benefits and the app most preferred by patients; and (d) dissemination of the project results to the participating asthma clinic and a professional conference. AsthmaMD and Asthma Ally were the evidence-based mobile apps selected to present to patients. These two apps were found to have the most complete evidence-based content available to the public. Each app can assist a patient to keep accurate self-recorded history to document medication adherence, symptoms, and exacerbations. Several functions found to be patient preferred with statistical significance are available in the AsthmaMD app. These functions include various ways for patients to learn about their asthma, a medication reminder, and monitoring medication adherence. Patient preference to have access to an environmental conditions monitor was found with statistical significance in the Asthma Ally app. AsthmaMD was reported by 64% of patients as having the most helpful app functions. Ninety-one percent of the participants expressed interested in using an asthma app for self-management of their asthm