Rajan K Merchant1, Rubina Inamdar2, Robert C Quade3. 1. Woodland Clinic Medical Group, Allergy Department, Dignity Health, Woodland, Calif. Electronic address: Merchant@dignityhealth.org. 2. Mercy Medical Group, Allergy Department, Dignity Health, Sacramento, Calif. 3. Quade and Associates, Sacramento, Calif.
Abstract
BACKGROUND: Telehealth strategies for asthma have focused primarily on adherence to controller medications. Telemonitoring of short-acting β-agonist (SABA) focuses on patterns of use and may allow more timely action to avert exacerbations. Studies assessing this approach are lacking. OBJECTIVE: This pragmatic controlled study was designed to measure real-world effectiveness of the Propeller Health Asthma Platform to reduce use of SABA and improve asthma control. METHODS:A total of 495 patients were enrolled in parallel arms (1:1) for 12 months of monitoring SABA use. Intervention group (IG) patients received access to and feedback from the Propeller Health system. Routine care (RC) patients were outfitted with sensors but did not receive feedback. Physicians were able to monitor the status of their patients in the IG and receive proactive notifications. RESULTS: The daily mean number of SABA uses per person decreased by 0.41 for the IG and by 0.31 for RC between the first week and the remainder of the study period (P < .001 for the difference between groups). Similarly, the proportion of SABA-free days increased 21% for the IG and 17% for RC (P < .01 for the difference between groups). Asthma Control Test (ACT) scores were not significantly different between arms in the entire study population, but adults with initially uncontrolled ACT scores showed a significantly larger improvement in the proportion with controlled asthma in IG versus RC (63% controlled in the study period vs 49%, respectively; P < .05 comparing the 2 improvements). CONCLUSIONS: Compared with RC, the study arm monitoring SABA use with the Propeller Health system significantly decreased SABA use, increased SABA-free days, and improved ACT scores (the latter among adults initially lacking asthma control).
RCT Entities:
BACKGROUND: Telehealth strategies for asthma have focused primarily on adherence to controller medications. Telemonitoring of short-acting β-agonist (SABA) focuses on patterns of use and may allow more timely action to avert exacerbations. Studies assessing this approach are lacking. OBJECTIVE: This pragmatic controlled study was designed to measure real-world effectiveness of the Propeller Health Asthma Platform to reduce use of SABA and improve asthma control. METHODS: A total of 495 patients were enrolled in parallel arms (1:1) for 12 months of monitoring SABA use. Intervention group (IG) patients received access to and feedback from the Propeller Health system. Routine care (RC) patients were outfitted with sensors but did not receive feedback. Physicians were able to monitor the status of their patients in the IG and receive proactive notifications. RESULTS: The daily mean number of SABA uses per person decreased by 0.41 for the IG and by 0.31 for RC between the first week and the remainder of the study period (P < .001 for the difference between groups). Similarly, the proportion of SABA-free days increased 21% for the IG and 17% for RC (P < .01 for the difference between groups). Asthma Control Test (ACT) scores were not significantly different between arms in the entire study population, but adults with initially uncontrolled ACT scores showed a significantly larger improvement in the proportion with controlled asthma in IG versus RC (63% controlled in the study period vs 49%, respectively; P < .05 comparing the 2 improvements). CONCLUSIONS: Compared with RC, the study arm monitoring SABA use with the Propeller Health system significantly decreased SABA use, increased SABA-free days, and improved ACT scores (the latter among adults initially lacking asthma control).
Authors: Chén C Kenyon; Siobhan M Gruschow; William O Quarshie; Heather Griffis; Michelle C Leach; Joseph J Zorc; Tyra C Bryant-Stephens; Victoria A Miller; Chris Feudtner Journal: J Asthma Date: 2018-02-13 Impact factor: 2.515
Authors: Yu-Feng Yvonne Chan; Pei Wang; Linda Rogers; Nicole Tignor; Micol Zweig; Steven G Hershman; Nicholas Genes; Erick R Scott; Eric Krock; Marcus Badgeley; Ron Edgar; Samantha Violante; Rosalind Wright; Charles A Powell; Joel T Dudley; Eric E Schadt Journal: Nat Biotechnol Date: 2017-03-13 Impact factor: 54.908
Authors: Molly A Martin; Melissa Gutierrez Kapheim; Kim Erwin; Stacy Ignoffo; Kate McMahon; Amy OʼRourke; Lynn B Gerald; Meredith Barrett; Valerie G Press; Houshang Darabi; Jerry A Krishnan Journal: Fam Community Health Date: 2018 Jul/Sep