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Allergy and Airway |

Interim Results From a Randomized, Controlled Trial of Remote Monitoring of Inhaled Bronchodilator Use on Asthma Control and Management

Rajan Merchant, MD; Rubina Inamdar, MD; Robert Quade, PhD; David Van Sickle, PhD; Matt Maenner, PhD; Michael Patmas, MD
Author and Funding Information

Asthmapolis, Madison, WI


Chest. 2013;144(4_MeetingAbstracts):71A. doi:10.1378/chest.1703281
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Abstract

SESSION TITLE: Asthma Diagnosis & Evaluation

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 02:45 PM - 04:15 PM

PURPOSE: While treatments and interventions for effective asthma management are well understood, asthma control continues to be suboptimal, resulting in frequent exacerbations, high healthcare utilization and costs, and decreased quality of life. Ambulatory monitoring of inhaled bronchodilators use through sensors and smartphone apps has the potential to improve self-management and provide physicians with a new perspective on disease control. This report summarizes interim results, as measured by frequency of rescue inhaler use, from an ongoing clinical trial.

METHODS: Patients at a hospital system in California are enrolled in a randomized, controlled trial, with allocation stratified by insurance type, language (Spanish or English) and level of control. Intervention group participants receive inhaler sensors and feedback through smartphone apps and online interfaces. Intervention patients’ physicians receive access to this data, and alerts if a patient falls below control thresholds. Control group patients are outfitted with sensors but do not receive feedback.

RESULTS: At 16 weeks, 216 patients (107 intervention, 99 control) had been enrolled (49% of 440 person target). At enrollment, the mean number of events per week did not differ (p=0.70) between control (3.55 ±5.74) and intervention groups (3.23 ±6.58). In a linear mixed model, over the first 60 days of participation the intervention group used their inhaler 0.14 times fewer per day or 1 event per week (p = 0.046) fewer when compared to the control group.

CONCLUSIONS: Remote monitoring of rescue inhaler use provides information valuable to guide and improve self-management and may help physicians identify patients who need more attention. Subsequent analyses will investigate any effects on healthcare utilization.

CLINICAL IMPLICATIONS: In standard practice, providers spend half of an appointment interviewing the patient about medication adherence, use of rescue inhalers and symptoms. Patient information recalled from the past 3-6 months is often unreliable and biased. Early results from this trial suggest sensor-monitored rescue inhaler use can provide the objective data physicians require. Rather than relying on recall data, provider dashboards illustrate real-time, objective summary data on their patient panel.

DISCLOSURE: David Van Sickle: Shareholder: DVS is a shareholder and officer in a company (Reciprocal Labs Corporation) that is developing an electronic inhaler sensor for commercial use. The company did not participate in this research study or finance this manuscript in any way. This does not alter the authors' adherence to all the CHEST policies on sharing data and materials., Employee: DVS is a shareholder and officer in a company (Reciprocal Labs Corporation) that is developing an electronic inhaler sensor for commercial use. The company did not participate in this research study or finance this manuscript in any way. This does not alter the authors' adherence to all the CHEST policies on sharing data and materials. The following authors have nothing to disclose: Rajan Merchant, Rubina Inamdar, Robert Quade, Matt Maenner, Michael Patmas

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