Sunit Jariwala, MD

Developers of a new mobile application hope they can enrich asthma patient knowledge, while also improving patient care.

In an interview with HCPLive®, Sunit P. Jariwala, MD, Division of Allergy/Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, said the ASTHMAXcel is an interactive mobile application that allows users to educate themselves on the condition through interactive modules and short movies.

Jariwala said through studies they found the app made an impact on asthma control, asthma knowledge, asthma quality of life, as well as a trend towards a decrease in asthma emergency department visits, hospitalizations, and steroid use.

In the pilot study, investigators conducted a focus group with asthma patients in the Bronx to identify the desired mobile app features, which directly led to the design of ASTHMAXcel.

The study included 60 patients, half of which were enrolled with the app and the other half in a human-educator group. Ultimately, patients were satisfied with the app, averaging 27.9 on a 30-point satisfaction survey.

One of the reasons the app is seen as a major accomplishment in improving patient care is that it has been clinical validated , where Jariwala said less than 1% of similar apps have been clinically validated.

He also said about 50% of apps are guideline based.

“So, our app has been thoroughly vetted against the guidelines—multiple iterations—and then clinically validated as well,” Jariwala said.

The investigators first began developing the application at the Montefiore Asthma Center in 2014, representing the first ever in-house application built at the center.

Since that time there has been both adult and pediatric versions that includes tailored push notifications, goal settings, and games for the child users.

The investigators are also working on developing similar applications for other conditions, including emphysema, congestive heart failure, diabetes, and rheumatoid arthritis.

Ultimately, Jariwala said since so many asthma patients have comorbidities the idea will be for all the different disease applications to be combined into a single, user-friendly platform.

However, developing the app was challenging as Jariwala had to help build a team of computer programmers and developers needed to actually create the useable app with the clinical content experts in the asthma space and other common comorbidities.

Another challenge for the team was user engagement.

“Most of these apps, there’s studies out there with 40,000 downloads and within six months 150 active users,” Jariwala said. “So how do we get patients to buy in day in day out? And we’ve tackled this in a few ways. For example, user feedback from patients and providers, you know, from predevelopment to iterative refinements, as well as a formal usability testing.”

Jariwala said another benefit is there is a behavioral scientist on their team looking at the motivational aspects of how patents get engaged on the app day-to-day.

The investigators were supposed to present data on the new during the American Academy of Allergy, Asthma & Immunology (AAAAI) 2020 Annual Meeting in Philadelphia, PA, but the conference was ultimately cancelled due to the coronavirus disease 2019 (COVID-19) outbreak.

The Montefiore team was scheduled to give a number of presentation on the new application, including 1 on how healthcare systems can develop and validate mobile apps of their own.

They also planned to present their pediatric data and the impact on clinical outcomes and healthcare utilization. The third presentation was about how to use patient input outcomes within the app to have patient generated health data and self-tracking.



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