A study by researchers at the Karolinska Institute has shown that a mobile phone app serving as the platform for a treatment algorithm based on lung function and symptoms can be an efficient tool for managing uncontrolled asthma.1 The phone measures lung function through a connection to a wireless spirometer; the app registers respiratory symptoms to provide visual feedback about treatment. The study results have led the researchers to develop a self-care system they call AsthmaTuner.
Asthma is a widespread disease that affects around 10% of Sweden’s population. Approximately half the affected people have so-called uncontrolled asthma and frequently experience breathing difficulties or asthma attacks. Common causes for the attacks are inadequate management of the condition, or incorrect use of medicines, or both.
“Previous research has shown that asthma sufferers’ health and quality of life improves with patient education that focuses on self-care, self-testing, and clear management plans,” says Björn Nordlund, PhD, pediatric nurse and research group leader in the department of women’s and children’s health at the Karolinska Institute. “Additionally, health and medical care costs fall if patient involvement and knowledge can be leveraged.”
Nordlund and his colleagues used the results of their study to develop their digital, automated, self-care system. AsthmaTuner enables users to measure lung function with a wireless spirometer connected to a mobile telephone app. Symptoms are evaluated through questions linked to an individual treatment plan. The system was approved for use in medical care in 2018. It is now marketed by MediTuner, a company partly owned by Nordlund.
“The system analyses lung function and symptoms in accordance with asthma care guidelines,” says Nordlund. “It then gives feedback in the form of automated, doctor-prescribed, treatment recommendations. Users also receive a picture of the inhaler that is to be used and instructions on whether the medication is to be maintained, increased, or decreased.”
The study was carried out at the Karolinska Institute and at the Astrid Lindgren Children’s Hospital. Its purpose was to evaluate the digital tool’s effects on symptoms, and whether users more readily remembered to take their medications.
The study comprised 77 uncontrolled asthma patients at least 6 years of age. Around half of the study subjects were children and adolescents. Study participants were randomly chosen to use AsthmaTuner for at least 8 weeks as a support for self-management, and to receive traditional asthma care with a printed, individual treatment plan for at least 8 weeks.
“In parts, the results were hard to interpret. However, we could see that asthma symptoms improved more with the digital tool than they did with traditional care,” says Nordlund. “Adult patients who used the tool at least once a week also more often remembered to take their medicines. Thus, we conclude that this tool can contribute to alleviating uncontrolled asthma sufferers’ symptoms.”
Because asthma requires long-term regular management, the researchers regarded the shortness of the study as a weakness, so they plan to continue the work. Nordlund says that the researchers don’t know whether the effects last longer than 8 weeks. They’ll begin a larger study in autumn 2019 that will run for a longer period.
AsthmaTuner was developed in collaboration with Region Stockholm and KI Innovations. Clinical testing was conducted by the Karolinska Trial Alliance. Henrik Ljungberg, MD, PhD, was the study’s first author. He and Nordlund are cofounders of MediTuner, which owns AsthmaTuner.
For more information, visit Karolinska Institute.
- Ljungberg H, Carleborg A, Gerber H, et al. Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomized controlled crossover trial. Eur Respir J. Published online September 3, 2019; doi: 10.1183/13993003.00983-2019.
Björn Nordlund, PhD (left), and Henrik Ljungberg, MD, PhD, Karolinska Institute.