RESUMO
BACKGROUND: Although digital health tools are increasingly recognized as effective in improving clinical outcomes such as asthma control and medication adherence, few studies have assessed patient experiences and perception of value. OBJECTIVE: The aim of this study was to evaluate patient satisfaction, perception of usability and value, and desire to continue after 12 months of using a digital health intervention to support asthma management. METHODS: Participants were enrolled in a randomized controlled study evaluating the impact of a digital health platform for asthma management. Participants used electronic inhaler sensors to track medication use and accessed their information in a digital health platform. Electronic surveys were administered to intervention arm participants aged 12 years and older after 12 months of use. The survey assessed asthma control, patient satisfaction with the sensor device, and perception of the usability and value of the digital health platform through closed-ended and open-ended questions. Logistic regression models were used to assess the impact of participants' characteristics on survey completion, satisfaction, and perception of value. RESULTS: Of the 207 intervention arm participants aged 12 years and older, 89 submitted survey responses (42.9% response rate). Of these 89 participants, 70 reported being very satisfied (79%, 70/89) or somewhat satisfied (20%, 18/89) with the inhaler sensor device. Moreover, 93% (83/89) expressed satisfaction with the reports, and 90% (80/89) found the information from the reports useful for learning about their asthma. In addition, 72% (64/89) of the participants reported that they were interested in continuing to use the sensor and platform beyond the study. There were no significant differences in satisfaction with the device or the platform across participants' characteristics, including device type, age, sex, insurance type, asthma control, or syncing history; however, participants with smartphones and longer participation were more likely to take the survey. CONCLUSIONS: Electronic sensors and a digital health platform were well received by participants who reported satisfaction and perceived value. These results were consistent across multiple participants' characteristics. These findings can add to a limited literature to keep improving digital health interventions and ensure the meaningful and enduring impact on patient outcomes.
RESUMO
BACKGROUND: Telehealth strategies for asthma have focused primarily on adherence to controller medications. Telemonitoring of short-acting ß-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).