Telemedicine Program Improves Clinical Outcomes in Young Adults With Asthma

This article is part of Pulmonology Advisor’s coverage of the American Thoracic Society Virtual 2020 meeting.

Young adults with asthma experienced improved clinical outcomes after undergoing virtual care, known as a multi-level electronic medical record (EMR)-integrated smartphone-telemedicine program (TEAMS), according to study results presented virtually at the American Thoracic Society 2020 Virtual meeting, held August 5 to 10, 2020.

Increased rates of emergency room visits and medication adherence suggest an elevated burden of asthma with inadequate prevention care in young adults when transitioning from pediatric to adult care. Therefore, researchers sought to examine the effect of TEAMS on patients struggling with asthma care. The virtual care included smartphone asthma symptom monitoring, a telemedicine follow-up, and 1:1 self-management training with a nurse.

Patients aged 18 to 44 years (mean age, 33.39 years) were selected from a safety net primary care practice in New York to undergo a 6-month pilot study. A total of 66.7% of the patients were women, 48.5% were Black, 21.2% were White, 12.% were multi-racial, 12.1% were Hispanic/Latino, and 3.0% were Asian. The majority of the patients reported having uncontrolled asthma at baseline (80%), most had public insurance (78.8%), and 63.6% were employed with a full/part time job. During the study, the patients were evaluated at baseline, 3 months, and 6 months for asthma control, quality of life (QoL), and forced expiratory volume in 1 second (FEV₁). The patients were assessed using surveys, 1:1 interviews, paired t-tests, and descriptive statistics.

The patients underwent an average of 5 separate smartphone visits (range 2-9 visits) that lasted on average a total of 26 minutes. By 3 months, most patients (70%) reported having well controlled asthma and by the 6-month follow-up, 24 of the 30 patients (80%) reported having well controlled asthma.

Improvements in asthma control and asthma QoL had large effect sizes of more than double the minimum important difference (d=1.60, t=6.09, P <.001; and d=1.59, t=6.88, P <.001, respectively) with an increase of 5% in mean FEV₁ percent predicted. Furthermore, young adults reported better asthma control and that the TEAMS intervention positively affected their QoL in their end-of-study interviews.

Researchers concluded, “Personalized self-management training and support delivered through virtual care extension programs such as TEAMS may be an effective way to close the care gap and improve clinical outcomes.”

Reference

Mammen JR, Halterman J, Berliant MN, et al. Pilot study of an EMR-integrated smartphone-telemedicine program as a virtual primary care extension for underserved younger adults with asthma (TEAMS – Technology Enabled Asthma Management System). Presented at: American Thoracic Society 2020 Virtual; August 5-10, 2020. Abstract #819.

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