Mobile App Improves Asthma Controller Refills Among Children, Teens

A new smartphone app could improve pediatric patient adherence to asthma controller therapies, according to study results.

In new trial data presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2019 Scientific Meeting in Houston this week, a New York-based team of investigators led by author Venkatesh Sabhae Gangadharappa, MD, presented findings showing mobile app “Ask Me, AsthMe!” was associated with a nearly-month’s length of time improvement in mean controller therapy refill among pediatric and adolescent patients.

According to the Apple App Store, the app is owned by the New York City Health and Hospitals Corporation, and is compatible in both English and Spanish. It includes telephonic reminders on due dates for controller therapy refills.

As Gangadharappa and colleagues noted, poor asthma controller therapy adherence is a major driver of uncontrolled asthma—and eventually, increased healthcare utilization costs among medically underserved children.

“Asthma smartphone technologies may improve medication adherence and result in improved health outcomes,” investigators wrote. “This study assesses medication refill data as an indicator of controller adherence while using a phone app.”

The team reviewed electronic prescribing profiles for average 30-day dispensed refills for controller medications before and after downloading the app.

The observed patient population was 107 patients aged 2-18 years old with asthma controlled with inhaler medication. Mean patient age was 8.67 years old, with a near-even split of males (51%) and females (49%). A majority of patients were African American (84.2%), and 55% (n = 59) suffered from persistent asthma.

Among them, most patients had moderate persistent asthma (44.5%), followed by mild (23.6%), then severe (1.8%).

Investigators observed mean days for corticosteroid controller refills prior to app use was 51.22 days. After app use, it had decreased to 32.32 days (P <.001). Among patients refilling Montelukast prescription, mean days to refill similarly decreased from 53.28, to just 33.77 days (P = .001).

Overall, 30-day refill adherence for inhaled corticosteroids was observed among 39% of patients prior to app use. Afterward, the rate jumped to 81.4% of patients. For Montelukast, 30-day refill adherence rates increased from 30.2% to 74.4% of patients.

At a time when inhaler adherence remains a major driver of uncontrolled asthma—and when telemedicine measures such as digital inhalers are being introduced to better patient use&mdash;Gangadharappa and colleagues advocated for the use of sanctioned apps such as “Ask Me, AsthMe!”

“Based upon the improved 30 day refill rates of patients using “AMAM,” asthma app functionality should include telephonic medication reminders to encourage adherence,” they concluded.

The study, “Controller Medication Refill Rates in Underserved Pediatric Asthma Patients After Use of a Smartphone Application,” was presented at ACAAI 2019.