Digital health tools can promote disease self-management, but the association of smartphone app engagement and medication adherence is unclear. We assessed the relationship between objective smartphone app engagement and controller medication use in adults with asthma and COPD. We retrospectively analyzed data from participants enrolled in a digital self-management platform for asthma and COPD. Eligible adults had a smartphone and a paired electronic medication monitor (EMM). Longitudinal, mixed-effects logistic regressions estimated the relationship between daily app engagement (app opens, session duration) and daily controller medication use. Data from 2309 participants (71% asthma; 29% COPD) was analyzed. Opening the app (vs. not opening the app) was associated with significantly greater odds (OR (95% CI)) of using controller medications in asthma (2.08 (1.98, 2.19)) and COPD (1.61 (1.49, 1.75). Longer session duration was also associated with greater odds of using controller medications in asthma and COPD, but the odds of use attenuated with longer session duration in COPD. This study presents a novel assessment of the relationship between objectively-measured smartphone app engagement and controller medication use in asthma and COPD. Such insights may help develop targeted digital health tools and interventions.
Environmental exposures and socioeconomic status (SES) are associated with asthma and chronic obstructive pulmonary disease (COPD) morbidity and mortality. Despite efforts to reduce the impact of environmental exposures through regulation and education, knowledge gaps remain. We sought to understand how adults with asthma and COPD perceive and seek information about environmental factors, and how these responses varied by disease or socioeconomic characteristics. Participants with self-reported asthma or COPD enrolled in a digital platform for respiratory disease self-management, consisting of sensors to track medication use and a companion smartphone app, completed an electronic survey exploring perceptions of environmental factors. Using mixed-method analyses, we evaluated differences in responses by disease (asthma vs. COPD), education (≤ vs. > some college), annual household income (< vs. ≥ $50,000), and mean annual residential air pollutant exposure (> vs. ≤80th percentile). Survey responses from 698 participants [500 asthma (72%) and 198 COPD (28%)] were analyzed. A high percentage of participants perceived that environmental factors could influence their symptoms, including: pollen (93% for asthma vs. 86% for COPD), mold (89 vs. 85%), second-hand smoke (89 vs. 83%), and air pollution (84% for both). Participants reported seeking environmental information daily from an average of three sources, preferring mobile apps and television (TV) programs. Significant differences were identified by disease.ConclusionParticipants with asthma and COPD perceive a relationship between their respiratory symptoms and their environment and regularly seek out environmental information. This information can help inform digital health development for respiratory education and self-management.
Digitale Gesundheitstools können die Selbstüberwachung von Krankheiten fördern, aber der Zusammenhang von Smartphone-App-Engagement und Medikamentenadhärenz ist unklar. Wir bewerteten den Zusammenhang zwischen dem objektiven Smartphone-App-Engagement und der Anwendung von Controller-Medikamenten bei Erwachsenen mit Asthma und COPD. Wir analysierten retrospektiv Daten von Teilnehmern, die auf einer digitalen Selbstüberwachungsplattform für Asthma und COPD angemeldet waren. Qualifizierte Erwachsene hatten ein Smartphone und einen gekoppelten elektronischen Medikamentenmonitor (EMM). Längsschnittliche logistische Regressionen mit gemischten Effekten schätzten die Beziehung zwischen täglichem App-Engagement (App-Öffnungen, Sitzungsdauer) und täglicher Controller-Medikamentenanwendung. Es wurden die Daten von 2309 Teilnehmern (71% Asthma; 29% COPD) analysiert. Das Öffnen der App (im Vergleich zum Nichtöffnen der App) war mit signifikant höheren Chancen (OR (95%-KI)) der Controller-Medikamentenanwendung bei Asthma (2,08 (1,98; 2,19)) und COPD (1,61 (1,49; 1,75)) verbunden. Eine längere Sitzungsdauer war auch mit einer größeren Wahrscheinlichkeit verbunden, dass bei Asthma und COPD Controller-Medikamente angewendet wurden, aber die Wahrscheinlichkeit einer Anwendung verringerte sich mit einer längeren Sitzungsdauer bei COPD. Diese Studie präsentiert eine neuartige Bewertung des Zusammenhangs zwischen objektiv gemessenem Smartphone-App-Engagement und Controller-Medikamentenanwendung bei Asthma und COPD. Solche Erkenntnisse können dazu beitragen, gezielte digitale Gesundheitsinstrumente und -interventionen zu entwickeln.
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