ASTHMAXcelED: A Patient-Facing Asthma Mobile Application with High User Acceptance and Improved Clinical Outcomes

Well-designed mobile health (mHealth) applications can improve patient outcomes; however few clinically tested apps are developed with user-centric design. ASTHMAXcelED is a patient-facing mobile application designed for emergency department (ED) asthma patients.

We studied user acceptance of the application and compared asthma control and quality of life measures before and after use of ASTHMAXcelED.

This prospective cohort study was conducted in two large urban EDs. Inclusion criteria were patients ≥18 years, English literacy, smartphone access, and discharge from the ED diagnosed with asthma exacerbation. ASTHMAXcelED was downloaded onto participants' phones upon discharge. Asthma symptom control was measured using the Asthma Control Test (ACT). User acceptance of and intention to use the application after the study period was measured using a Unified Theory of Acceptance and Use of Technology.

A total of 149 participants were enrolled in the study, of which 124 completed follow-up visits. The proportion of patients with good asthma control (ACT > 19) improved from 27% at baseline to 54% at 4-week follow-up, p  < 0.01. The rate of ED revisit was 7% and hospitalization for asthma was 0%. A total of 39% of patients indicated they intended to continue using ASTHMAXcelED in the next 6 months, whereas 5% did not.

While using ASTHMAXcelED for 4 weeks, participant's asthma symptom control and quality of life scores improved. Their ED revisit rate and asthma hospitalization during the study period were low. ASTHMAXcelED may be an easily adopted mhealth education platform that can improve patient outcomes.