Assessing Asthma Management Via Mobile App vs Human-Delivered Education

ASTHMAXcel, a novel guideline-based smartphone app designed to promote asthma education, resulted in improvement in Asthma Knowledge Questionnaire scores.

When the novel, guideline-based smartphone application ASTHMAXcel, which was designed to promote asthma education, was compared with the use of human-delivered asthma education, although improvements in scores on the Asthma Knowledge Questionnaire (AKQ) were reported, the group that received human education experienced greater increases in AKQ scores. Results of the analysis were published in the Journal of Asthma.

Investigators sought to compare the effect of ASTHMAXcel with human-delivered education in a group of patients with asthma at the outpatient multispecialty Montefiore Asthma Center (MAC) in the Bronx, New York, between May 2015 and May 2016. The researchers conducted a focus group in individuals with asthma to identify the desired features of the mobile app. ASTHMAXcel, which was designed based on patient feedback, was consistent with National Asthma Education and Prevention Program (NAEPP), British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN), and Global Initiative for Asthma (GINA) guidelines. The ASTHMAXcel app was reviewed by internists, pulmonologists, and allergists/immunologists who specialized in asthma treatment, along with asthma educators and a behavioral scientist. The refined version of the ASTHMAXcel app was administered once at MAC via the use of a tablet. At the same time, human-delivered asthma education was also delivered once at MAC.

A total of 60 patients with asthma were enrolled in the study, 30 of whom were in the ASTHMAXcel group and 30 in the human-education group. All study patients were ≥age 18 years and were willing to complete the asthma education (mobile-based or human-delivered) intervention and study questionnaires. All study enrollees needed to have a clinical history of physician-diagnosed asthma, use daily controller inhaler medications, and be English-speaking.

The mean AKQ scores in the ASTHMAXcel group vs the human-education group pre-intervention were 9.9 vs 10.5, respectively (P =.27). Post-intervention, however, mean AKQ scores were 12.3 in the ASTHMAXcel arm vs 14.4 in the human-educator arm (P =.0002).

The mean improvement in AKQ score was 2.4 in the ASTHMAXcel group compared with 3.9 in the human-educator group (P =.007).

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Patients in the ASTHMAXcel group reported being highly satisfied, scoring an average of 27.9 points out of a maximum of 30 points on the satisfaction survey. No differences were observed between the 2 interventions in either satisfaction scores or completion times (in minutes).

The investigators concluded that the study findings showed that the future of smartphone apps for the management of asthma is promising. They plan to expand on these results to enhance the patient experience. Based on the preliminary nature of the study, future studies are warranted with larger sample sizes to confirm these findings.

Disclosure: This study was supported by Genentech. Please see the original reference for a full list of authors’ disclosures.


Hsia B, Mowrey W, Keskin T, et al. Developing and pilot testing ASTHMAXcel, a mobile app for adults with asthma [published online February 19, 2020]. J Asthma. doi:10.1080/02770903.2020.1728770