A Pilot and Feasibility Study of Mobile-Based Asthma Action Plans

A written Asthma Action Plan from a healthcare provider is one of the key features of asthma
self-management recommended by the National Asthma Education and Prevention Program asthma
guidelines; guidelines-based asthma care has not yet fully translated to the community
despite the fact that National Asthma Education and Prevention Program released the first set
of national guidelines nearly 2 decades ago. Previous reports have proven that patients with
an Asthma Action Plan have better outcomes including fewer acute healthcare utilization
visits, fewer days missed from school, and improved symptoms scores compared to patients
without an Asthma Action Plan. Recently, mobile-based phone applications and music file (MPEG
layer 3)(MP3) players have been utilized in the management of chronic diseases such as asthma
and diabetes to provide medication reminders and to provide alternatives to paper dairies for
logging symptoms or other health-related data such as peak flow readings or blood glucose
readings. We propose to design an application that will fully meet the recommended
individualized Asthma Action Plan treatment plan as recommended by national guidelines and
will also provide participants with medication reminders, education tips, and data
logging/tracking capabilities.

Inclusion Criteria:

- Age ≥ 12 and ≤ 17 years.

- Mild to severe persistent asthma or poorly controlled asthma. If a child has used a
preventive medication in the past, but reports no use of the medication in the prior 3
months, we will assess severity.

- Children not using a preventive medication at baseline: We will assess for mild
persistent to severe persistent asthma. Any one of the following, during the prior 4
weeks (as defined by parent interview) will determine severity:

- An average of >2 days per week with asthma symptoms

- >2 days per week with rescue medication use

- ≥2 nights per month awakened with nighttime symptoms

- Minor limitation of activity

- ≥2 episodes of asthma during the past year that have required systemic
corticosteroids.

- Children using a preventive medication at baseline: We will assess for poorly
controlled asthma. Any 1 of the following, during the prior 4 weeks (as defined by
parent interview in the waiting room) will determine control:

- An average of >2 days per week with asthma symptoms

- >2 days per week with rescue medication use

- ≥2 nights per month awakened with nighttime symptoms

- Some limitation of activity

- ≥2 episodes of asthma during the past year that have required systemic
corticosteroids.

Exclusion Criteria:

- Significant underlying respiratory disease other than asthma (such as cystic fibrosis
or chronic lung disease) that could potentially interfere with asthma-related outcome
measures.

- Significant co-morbid conditions (such as moderate to severe developmental delay, i.e.
special education classroom or diagnosis) that could preclude participation in an
education-based intervention.

- Inability to speak or understand English (child or parent).

- Children in foster care or other situations in which consent cannot be obtained from a
guardian.

- Prior enrollment in the study.