Technology-Based Asthma Interventions Can Reduce the Health Outcomes Gap

Many patients with asthma benefit from the application of technologies for behavior modification, symptom monitoring, education, and treatment decision making, but whether such applications can improve the care of minority, inner-city asthmatics has been unclear.

However, a literature review recently published in The Journal of Allergy and Clinical Immunology: In Practice has shown that tech-based asthma interventions have a high rate of user satisfaction among minority and urban or low-income patients and can improve asthma outcomes in these populations. The literature review covered all randomized controlled trials of technological interventions in minority populations from 2000 to 2015.

Interventions used the following technologies:

• MPEG audio layer-3 players
• Text messaging
• Computer- or web-based systems
• Video games
• Interactive voice response

Users were not only satisfied with these interventions but also experienced improvements in knowledge of asthma, medication adherence, asthma symptoms, and quality of life because of them. Nevertheless, these interventions did not reduce visits to the emergency department or hospital admissions. Computer-based interventions produced the most positive results, although no single intervention method was vastly better than another.

In related news, the Health and Environmental Tracker (HET), an integrated, low-power system that monitors asthma patients and their environment, is being developed at North Carolina State University. The system uses nanotechnology to minimize power consumption, and its developers are attempting to reduce that consumption to the sub-milliwatt level so that the HET can be powered solely by energy generated from body heat and movement. A description of the system, which includes a wristband, a chest patch, and a handheld spirometer, was recently published in IEEE Xplore.

The goal of HET’s developers was to design a wearable monitoring system that could be used to predict asthma attacks and warn users of an impending attack. Such warnings could then help users take steps to prevent an attack by, for example, going indoors or taking an exercise break.

The HET wristband monitors the environment for ozone and volatile organic compounds as well as temperature and relative humidity and monitors the user’s movement, heart rate, and blood oxygen saturation. Sensors in the chest patch also measure these physiologic parameters as well as skin impedance, respiratory rate, and wheezing.

The handheld spirometer is the one non-wearable component of the system. Users breathe into it several times a day so expiratory airflow can be measured. The customized, self-powered spirometer developed for HET collects more accurate information on lung function than a peak flow meter, which asthma patients are typically asked to use daily. And the HET spirometer feeds the data it collects into the system for further analysis.

Data from each sensor or component in the HET is continually streamed to a peripheral data aggregator then transferred to a dedicated server for storage in the cloud. After the data is collected and stored, environmental conditions can be correlated with physiologic responses and subsequent adverse health effects.

The team plans to test the HET in both asthmatics and controls this summer to identify which variables predict asthma attacks. This step will allow them to develop software to track user data automatically and warn users about pending asthma attacks. The team also plans to develop software to sync the HET with smart phones so users can monitor their health on the go.