Which digital health interventions are most effective in asthma?
Published online: June 1, 2021
It is estimated that the global number of patients with asthma now approaches 350 million. Although clinically effective treatments are widely available, asthma continues to be associated with excessive suffering, including uncontrolled symptoms, reduced quality of life, substantial healthcare use, ballooning costs and death. A major contributing factor to poor outcomes is the long-term commitment to self management required of asthma patients across all age groups. Poor adherence to maintenance controller medication remains widespread, as does poor inhaler technique. In recent years, several different digital interventions – with varying degrees of interactivity and personalization – have been developed to attempt to address these issues.
A recent scoping review article developed by Giselle Mosnaim, MD, MS and colleagues and published in The Journal of Allergy and Clinical Immunology: In Practice evaluated published research on digital interventions for asthma. A literature search was conducted, and the quantity and scope of relevant articles was assessed. Of 871 articles identified, 121 were included in the review, researchers examined the design of each digital intervention and their effect on asthma symptoms, before exploring the feedback of patients and clinicians. Interventions were subsequently categorized based on their degree of interactivity.
While participants receiving content that was not individually tailored displayed improvements in medication adherence, their overall level of impairment due to asthma typically did not improve. However, patients receiving an intervention involving two-way communication with their clinician more often achieved both improved adherence and reduced impairment. Digital interventions were generally positively perceived by patients and clinicians, and their implementation into clinical practice was felt to be achievable. Therefore, digital technology shows substantial promise for monitoring and personalizing asthma treatment. The review authors conclude by recommending that effective digital interventions should combine accurate disease monitoring with design elements preferred by patients and clinicians, including ease of use, personalization and individual engagement.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.