This article is a collaboration between MedPage Today and:
ATLANTA -- The use of a mobile health app did not reduce urgent healthcare utilization in a high-risk cohort of nearly 200 children with asthma compared with controls, researchers reported here.
Although new mobile health apps for asthma management continue to be developed, there have been few studies evaluating the clinical utility and outcomes of these apps, according to , of Nationwide Children's Hospital in Columbus, Ohio, and colleagues.
Action Points
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
There was no significant differences for healthcare utilization after 6 months between those using an app called Asthma Care and a control group, which received online asthma information, they reported in a poster at the American Academy of Allergy, Asthma & Immunology annual meeting.
However, Stukus told MedPage Today that "Our study is statistically underpowered, because if you look at total number of emergency departments [ED], not all patients had them in the 6 months before. There were only a few events. It is possible that on a larger scale, or with a longer period time, we might see more of a difference, but we're not going to make any claims that it worked because it didn't compared with the control."
Stukus added that "we feel that there is something there and that if we had a larger group we might see something."
His group developed as a tool to provide patients with a treatment plan, medication reminders, trigger avoidance tips, and medication and symptom diary.
They conducted a 6-month prospective, randomized, controlled trial with nearly 200 children, ages 6 months to 21 years, at Nationwide Children's Hospital. All children had persistent asthma and presented with an asthma exacerbation to the ED within the past 6 months.
Patients using Asthma Care were slightly older than controls (7.84 versus 6.24 years). Gender (55% versus 62% male), race (83% versus 77% African American), and insurer (89% versus 98% Medicaid) were similar between the two groups.
The researchers then used chi-square analysis to compare categorical square and the Mann-Whitney U test to evaluate continuous data.
Stukus' group found that Asthma Care participants had a 72% reduction (29 versus 11) in urgent care visits (P=0.02), while controls had a 24% reduction (25 versus 19, P=0.43).
Asthma Care participants with more than two comorbidities had an 88% reduction (17 versus two) in urgent care visits (P=0.01) while controls had an 11% reduction (nine versus eight, P=0.82).
No differences were seen according to age, race, insurer, or level of baseline therapy.
Specific patient populations and characteristics may make chronic asthma management more amenable to use of mobile apps, Stukus noted, adding that future studies of mobile health apps should incorporate methodology and clinically meaningful outcomes to determine efficacy.
Primary Source
American Academy of Allergy, Asthma & Immunology
Stukus DR, et al "Use of a mobile health application in children with persistent asthma: A randomized controlled trial " AAAAI 2017.