An Electronic Shared Decision-Making App to Improve Asthma Outcomes: A Randomized Controlled Trial.

Area of Science:

• Digital health interventions
• Patient-centered care
• Asthma management

Background:

• Shared decision-making (SDM) is crucial for optimizing asthma management by integrating patient values and preferences.
• Existing asthma SDM tools predominantly focus on medication choices, potentially overlooking other critical aspects of care.

Purpose of the Study:

• To evaluate the usability, acceptability, and preliminary effectiveness of the ACTION (Active Conversation in asthma Treatment shared decisION-making) app.
• The ACTION app was designed to address patient concerns related to medication, nonmedication factors, and COVID-19 in asthma care.

Main Methods:

• A pilot study randomized 81 asthma participants into a control group or the ACTION app intervention group.
• Participants completed the ACTION app pre-clinic visit, with responses shared with providers. Primary outcomes included patient satisfaction and SDM quality.
• Qualitative data were gathered through virtual focus groups with ACTION app users (n=9) and providers (n=5), followed by comparative analysis.

Main Results:

• The ACTION app group reported higher agreement that COVID-19 concerns were adequately addressed (P=.03).
• While the overall SDM Questionnaire score did not reach statistical significance, the ACTION app group showed stronger agreement on physician involvement in decision-making (P=.05) and thorough consideration of options (P=.03).
• Focus groups revealed the ACTION app was perceived as practical and effective in setting a patient-centered agenda.

Conclusions:

• An electronic SDM app for asthma, incorporating patient preferences on medication, nonmedication, and COVID-19 concerns, is well-accepted.
• This digital tool demonstrates potential to enhance patient satisfaction and the quality of shared decision-making in asthma care.