Evidence Based Patient Centric App Review Series
Goals of app review:
- To determine if AsthmaMD can be used by patients to improve control of their asthma symptoms.
- Additionally, a goal is to determine if physicians would find AsthmaMD of benefit if patients log peak flows, symptoms, and triggers on a regular basis.
- To determine if there is evidence to show these tools can improve the management of asthma
Dr. Sam Pejham, a UCSF medical doctor and researcher, created this app to allow asthmatics or their parents to log asthma activity.
It includes a diary of peak flow measurement, symptoms, triggers and notes as well as a peak flow chart. It also allows the input of medications. The diary and chart can be emailed to the patient’s provider (or anyone else). This app is also being used as a research tool by Dr. Pejham by anonymously gathering patient data. There is an “opt-out” feature for patients who don’t want to submit their personal information.
Opening screen is for data entry, which is one click to each input area and easy to use. Peak flows can be entered via the keypad or a “wheel” system.
The diary screen gives the user a synopsis of all data input and the ability to send a report to the user’s healthcare provider from this screen.
The chart is visually clear as to how well the user’s asthma is doing based on peak flow measurements.
The settings page allows for password protection of the app on the user’s device, a way to opt out of the secure, anonymous transmission of asthma data, addition of multiple users, reminder settings, and multiple educational links including a video on how to use the app, as well as FAQs regarding the app and the license agreement.
Healthcare goals of app:
As directly quoted from the app’s support sight: “To make it very easy for patients or their parents to keep a diary of Peak Flow Measurements, take appropriate action as prescribed by their physician, and send this information to their healthcare provider.”
Evidence to support goals:
There are ongoing studies of the use of telemonitoring, not specifically smartphone apps, to support patients with chronic diseases , including pulmonary studies. There is a substantive enough body of evidence for asthma-specific guidelines to conclusively state that this improves patient outcomes.
The evidence for the use of peak flow monitoring in improving asthma outcome is not completely conclusive [2,3,4] but coupled with symptom reporting has been determined to reduce ER visits and use of rescue medications. The NIH clinical guidelines recommend following EITHER peak flow or symptoms. This app does both.
- Multiple users supported
- Easy to use
- Visually appealing with charts that clearly illustrate how well the user’s asthma is controlled
- Both written and video explanation of how to use the app
- Data can be emailed to healthcare provider
- Tracks medications
- Password protection
- Ability to easily adjust settings for “well”, “worse” and “critical”
- Disclaimer and explanation of encrypted, anonymous data collection should be more obvious, instead of hidden in the settings area–default is set to “opt in”
- Suggested additional feature: The ability to print logs and charts for users whose providers do not utilize email in patient care
Summary of the app:
AsthmaMD was designed to help patients and their providers monitor peak flow, symptoms, triggers and medication use as well as anonymously track data for researchers to determine cause and geographical region in asthma flares. It is visually appealing, intuitive to use, and covers the recommendations for asthma monitoring put forth by the NIH and other entities that develop chronic disease care guidelines.
What type of provider would best benefit from this app:
Family Practitioners, Pediatricians, Pulmonologists and Allergists
Physicians should consider recommending this app to patients with asthma or their caregivers. Its use can be quickly demonstrated and the data gathered by the patient can be used to change medications as well as monitoring triggers. It would be most useful in smartphone savvy patients with motivation to self-monitor. Self-management of asthma in some studies has shown a reduction in exacerbations and hospital ER visits.
Paré, Guy. Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base. URL:http://jamia.bmj.com/content/14/3/269.full. Accessed: 2012-07-11. (Archived by WebCite® at http://www.webcitation.org/695huiWOA)
McGrath, AM. Is home peak expiratory flow monitoring effective for controlling asthma symptoms? J Clin Pharm Ther. 2001 Oct;26(5):311-7.
Cowie, RL. The effect of a peak flow-based action plan in the prevention of exacerbations of asthma. Chest. 1997 Dec;112(6):1534-8.
Wensley, D. Peak flow monitoring for guided self-management in childhood asthma: a randomized controlled trial. Am J Respir Crit Care Med. 2004 Sep 15;170(6):606-12. Epub 2004 Jun 7.
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.