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A Digital Asthma Self-Management Program for Adults: A Randomized Clinical Trial.

Jordan Silberman1, Siavash Sarlati2,3, Bronwyn Harris4

  • 1Office of Medical Policy and Technology Assessment, Elevance Health Inc, Palo Alto, California.

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A digital asthma self-management (DASM) program improved asthma control in adults compared to usual care. Further adaptations may enhance benefits across diverse patient populations.

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Area of Science:

  • Digital health
  • Asthma management
  • Clinical trials

Background:

  • Digital health technologies show promise for improving asthma self-management.
  • Evidence regarding the effectiveness of digital asthma self-management programs is limited.
  • Adult asthma self-management requires innovative and accessible solutions.

Purpose of the Study:

  • To investigate the impact of a digital asthma self-management (DASM) program on asthma symptoms in adults.
  • To evaluate the efficacy of an app-based intervention for improving asthma control.
  • To assess the effect of a DASM program on patient-reported outcomes.

Main Methods:

  • A randomized, pragmatic, parallel-arm, open-label, decentralized clinical trial was conducted.
  • Adults with asthma were randomized to either the DASM program or usual care.
  • The DASM program included tailored notifications, symptom logging, and wearable device integration.

Main Results:

  • Participants with uncontrolled asthma at baseline showed significant improvements in Asthma Control Test (ACT) scores with the DASM program compared to usual care (2.8-point difference, P < .001).
  • The positive effect of the DASM program on asthma control was more pronounced in participants not identifying as African American.
  • No significant moderation of the DASM program's effect was observed based on insurance status or ethnicity.

Conclusions:

  • The digital asthma self-management (DASM) program demonstrated improved asthma control compared to usual care in a randomized trial.
  • The findings suggest that digital health interventions can effectively support asthma self-management.
  • Program adaptations may be necessary to ensure equitable benefits across diverse patient populations.