A text-based reminder system helped patients follow their Asthma Action Plans more closely.
Breathing is such an automatic process that it can be easily overlooked. Yet, for many asthma sufferers, that is not always the case. To help asthma patients manage their symptoms, health care providers often instruct them to use an Asthma Action Plan (AAP). AAPs have traditionally been paper-based, but a new study led by Vancouver Coastal Health Research Institute researchers is testing the efficacy of an electronic AAP (eAAP) with text-based reminders.
“The intent of this study is to see if we can make it easier for patients to access their Asthma Action Plans using their smartphones,” says Dr. Iraj Poureslami, senior health evaluation scientist with the Centre for Clinical Epidemiology and Evaluation (C2E2).
Asthma is a chronic condition that affects the lungs and can make it difficult to breathe. AAPs are personalized plans created with a health care provider to help patients self-assess their symptoms and track their medication. They also help health care providers design and modify treatments for patients. AAPs let patients know if their symptoms are in the ‘green zone’, i.e., safe, or if they need to speak with a care provider soon, ‘yellow zone’, or seek immediate medical attention, ‘red zone’.
Poureslami is the first author of the study, published online in the Journal of Asthma. Poureslami and co-authors compared 52 patients who were given access to their own personalized eAAPs with a control group of 54 patients who used the paper-based AAP. All patients were previously diagnosed with asthma and had experienced at least one asthma attack or exacerbation within the 12 months prior to participating in the study.
“The paper form was sometimes harder for patients to understand and can be easily misplaced or forgotten,” explains Poureslami. “The electronic version gives patients easy and timely access to their action plans, along with additional online information to help them manage their symptoms.”
Smartphone technology improves outcomes for asthma patients
A serious and chronic condition, asthma can significantly impact the quality of life of patients and their families. It can often result in missed work or school days, and numerous trips to the doctor and, sometimes, hospital.
For Poureslami and colleagues’ study, participants in the eAAP group were able to sign into a secure website to access their personalized action plans using only a smartphone and an internet connection. Participants also received a weekly text messages reminding them to check their symptoms and action plans. If a participant did not reply to the text message from the research team within a few days, he or she would receive a reminder text message. If a couple of weeks went by without the participant responding, he or she would receive a follow-up phone call from the study research coordinator and, if needed, would be referred to a certified respiratory educator—an expert who helps asthma patients manage their symptoms.
“Participants reported feeling more connected to their action plans and the management of their symptoms when they received a text message.”
The study results show that patients in the eAAP group had fewer asthma attacks or exacerbations compared to patients in the paper-based AAP group. The eAAP group also reported greater asthma control and quality of life.
The next step, Poureslami says, is to run a larger trial with more asthma participants, and include a French version of the eAAP. He would like to produce an app that would give participants access to their personalized eAAPs even without an internet connection. Poureslami would also like to implement a text-based response system that participants can use to pose questions to and receive responses from a certified respiratory educator or study team member.
“The health care system is changing and our population is getting older. We need more efficient ways to provide services to patients to ensure a high standard of care.”