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Real-world evaluation of a mobile health application in children with asthma
David R Stukus1, Nabeel Farooqui2, Kasey Strothman1
1Division of Allergy and Immunology, Nationwide Children's Hospital, Columbus, Ohio.
Insights
A mobile asthma app did not significantly reduce emergency visits or hospitalizations in children. While not reducing healthcare usage, app users reported better asthma management compared to controls.
Area of Science:
- Pediatric Pulmonology
- Digital Health
- Clinical Trials
Background:
- Mobile health applications are emerging for asthma management.
- Limited randomized controlled trials exist to evaluate their efficacy in reducing exacerbations.
Purpose of the Study:
- To assess the impact of a mobile asthma application on asthma-related urgent healthcare utilization.
Main Methods:
- A 6-month prospective randomized controlled trial was conducted.
- Patients aged 6 months to 21 years with persistent asthma were randomized to an app (AsthmaCare) or online information.
- Primary outcomes included emergency department visits, urgent care visits, and hospitalizations before and after randomization.
Main Results:
- No significant reduction in emergency department, urgent care visits, or hospitalizations was observed between groups.
- Participants using the AsthmaCare app reported a higher likelihood of improved asthma management (79% vs. 64%).
Conclusions:
- This randomized controlled trial found no significant decrease in asthma-related emergency department visits or hospitalizations with mobile health app use.
- Further research may be needed to optimize mobile health interventions for pediatric asthma management.
Background:
Mobile health applications for asthma are increasingly being developed. However, there are no published randomized controlled trials evaluating efficacy in decreasing exacerbations.
Objective:
To evaluate the impact of a mobile asthma application for asthma-related urgent health care usage.
Methods:
We conducted a 6-month prospective randomized controlled trial for patients (6 months-21 years old) with persistent asthma presenting with an asthma exacerbation to the emergency department of a pediatric academic medical center. Participants were randomized to AsthmaCare (application providing medication and trigger reminders and treatment plan) or the control (online asthma information). Primary outcome measures were comparison of emergency department and urgent care visits and hospitalizations 6 months before and after randomization.
Results:
AsthmaCare participants (n = 98) were slightly older (7.84 vs 6.24 years; P = .02) than controls (n = 95) but similar for sex (55% vs 62% boys), race (83% vs 77% African American), and insurer (89% vs 98% Medicaid). The 2 groups were similar in having more than 2 comorbidities (34% vs 32%) and receiving National Heart, Lung, and Blood Institute step 3 treatment or higher (69% vs 57%). There was no significant decrease in emergency department or urgent care visits or hospitalizations between the intervention and control groups. AsthmaCare participants were more likely to report improvement in asthma management 6 months after study enrollment (79% vs 64%; P = .06).
Conclusion:
This randomized controlled trial did not demonstrate a significant decrease in asthma-related emergency department visits or hospitalizations among children who used a mobile health application.
Trial Registration:
ClinicalTrials.gov, Identifier NCT02333630.
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