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Apps to manage asthma: are they ready for clinical practice?

Published online: September 7, 2020

There are currently hundreds of asthma-related mobile health (mHealth) applications (apps) available, varying widely in their features and functions. A 2019 analysis searched the word “asthma” in the Google Play and Apple App stores and identified 461 apps across both stores. Interestingly, 6 apps were consumer-directed and communicated with a sensor incorporated into the inhaler (i.e., an inhaler-based sensor), a more recent technological advancement. These apps were similar in functions such as recording inhaler use, reminding patients to take medicine, and informing of airborne triggers. How these apps impact health outcomes of patients with asthma is unclear, and such information is not readily available nor required in app stores. Furthermore, mHealth apps are not regulated by the Food and Drug Administration (FDA) unless they meet the definition of a mobile medical app. As a result, most asthma-related mHealth apps do not undergo rigorous review prior to patient use.

In a systematic review recently published in The Journal of Allergy and Clinical Immunology: In Practice, Nguyen and colleagues evaluated the effects of consumer-directed mHealth apps that integrate with an inhaler-based sensor on outcomes in patients with asthma. Investigators identified apps in the Google Play and Apple App stores and then searched for evidence evaluating these apps.

Investigators identified 6 mHealth apps but only 2 had published literature evaluating health outcomes across 7 studies. Altogether, mHealth apps that pair with an inhaler-based sensor have a positive impact on patient adherence to daily medications and help to reduce use of rescue inhalers such as albuterol. Patient satisfaction with using these apps was also documented. However, some studies suffered from methodologic limitations, and, furthermore, important health outcomes such as occurrence of asthma exacerbations and patient quality of life were not studied. More comprehensive evaluation of mHealth apps and their impact on health outcomes is needed before clinicians and patients can weigh the benefits against the resources needed to adopt these technologies. Such resources may include out of pocket costs covering devices or app subscriptions, time to learn how to interact with the app, and, for providers, how to integrate dashboards into patient care workflows.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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