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Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomised controlled crossover trial

Henrik Ljungberg, Anna Carleborg, Hilmar Gerber, Christina Öfverström, Jakob Wolodarski, Faiza Menshi, Mikaela Engdahl, Marianne Eduards, Björn Nordlund
European Respiratory Journal 2019; DOI: 10.1183/13993003.00983-2019
Henrik Ljungberg
1Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
2Department of Women's and Children's Health, Karolinska Institutet, Stockholm Sweden
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Anna Carleborg
1Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Hilmar Gerber
4Children and Adolescents Health Care Department in Huddinge, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Christina Öfverström
4Children and Adolescents Health Care Department in Huddinge, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Jakob Wolodarski
4Children and Adolescents Health Care Department in Huddinge, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Faiza Menshi
2Department of Women's and Children's Health, Karolinska Institutet, Stockholm Sweden
3Sophiahemmet Health Care Centre, Stockholm, Sweden
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Mikaela Engdahl
2Department of Women's and Children's Health, Karolinska Institutet, Stockholm Sweden
3Sophiahemmet Health Care Centre, Stockholm, Sweden
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Marianne Eduards
5Liljeholmen Health Care Centre, Stockholm Health Care Services (SLSO), Stockholm Count Council, Stockholm, Sweden
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Björn Nordlund
1Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
2Department of Women's and Children's Health, Karolinska Institutet, Stockholm Sweden
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  • ORCID record for Björn Nordlund
  • For correspondence: bjorn.nordlund@ki.se
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Abstract

Background AsthmaTuner is a novel self-management system consisting of a patient app, a cloud-based storage solution and a healthcare interface. Patients use Bluetooth spirometers to measure lung function (FEV1) and can register symptoms. They then receive immediate feedback on asthma control and an image of the correct inhaler(s) to use and the dose. The aim of this pilot study was to evaluate the effect of AsthmaTuner on symptom control and adherence compared with conventional treatment.

Material and Methods This multi-centre, physician-blinded, crossover trial, randomised patients in two groups that started with 8 weeks of AsthmaTuner or conventional treatment using printed personalised treatment plans, and 2 weeks of wash-out between the crossover treatments. Participants in a primary or paediatric care setting in Sweden with asthma diagnosis, uncontrolled symptoms and Asthma Control Test (ACT)<20 points were included. Symptom control was analysed using t-tests for the difference between the group means of the sums of ACT at each treatment end-visit, with 95% confidence intervals. Medical Adherence Report Scale scores captured differences in adherence (remembering to take asthma medication) between treatment periods.

Results The study population consisted of 77 patients (60% females). The ACT significantly improved with AsthmaTuner compared with conventional treatment (mean 0.70 [0.06–1.34], p=0.03). Adherence did not improve significantly in all participants, but did improve among those in primary care who used AsthmaTuner an average of once a week or more, compared with conventional treatment (mean 0.45 [0.13–0.77], p=0.01).

Conclusions AsthmaTuner improved symptom control in patients with uncontrolled asthma.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Ljungberg reports and Henrik Ljungberg is a co-founder and holds shares in the company Medituner that owns Asthmatuner.

Conflict of interest: Dr. Carleborg reports personal fees from Medituner AB, outside the submitted work; and I have warrants in the company Medituner.

Conflict of interest: Dr. Gerber has nothing to disclose.

Conflict of interest: Dr. Öfverström has nothing to disclose.

Conflict of interest: Dr. Wolodarski has nothing to disclose.

Conflict of interest: Dr. Menshi has nothing to disclose.

Conflict of interest: Dr. Engdahl RN has nothing to disclose.

Conflict of interest: Dr. Eduards has nothing to disclose.

Conflict of interest: Dr. Nordlund reports; B. Nordlund is a co-founder and holds shares in the company Medituner that owns Asthmatuner.

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Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomised controlled crossover trial
Henrik Ljungberg, Anna Carleborg, Hilmar Gerber, Christina Öfverström, Jakob Wolodarski, Faiza Menshi, Mikaela Engdahl, Marianne Eduards, Björn Nordlund
European Respiratory Journal Jan 2019, 1900983; DOI: 10.1183/13993003.00983-2019

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Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomised controlled crossover trial
Henrik Ljungberg, Anna Carleborg, Hilmar Gerber, Christina Öfverström, Jakob Wolodarski, Faiza Menshi, Mikaela Engdahl, Marianne Eduards, Björn Nordlund
European Respiratory Journal Jan 2019, 1900983; DOI: 10.1183/13993003.00983-2019
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