Phenotyping patients based on longitudinal heterogeneity of engagement patterns with the ASTHMAXcel PRO mobile health application

Abstract

Kids' Health Connections. RATIONALE: Digital asthma interventions have been associated with improved outcomes, but evidence among Medicaid-enrolled participants remains limited. We aimed to evaluate the impact of a digital asthma intervention, combined with a collaborative asthma education program, on SABA use among children in Detroit. METHODS: Children (ages 6-13) with asthma living in four ZIP codes of southwest Detroit were eligible to participate in the program sponsored by the Detroit Health Department. Participants were recruited by Kids Health Connection (KHC) to enroll in an asthma education program supplemented with electronic medication monitors (EMMs) to capture the date and time of SABA use, and a companion smartphone app to provide education, feedback and reminders. Caregivers and providers were invited to monitor the data and discuss trends with KHC. Paired t-tests (?50.05) estimated change in mean daily SABA use and SABA-free days from first to last month of participation. RESULTS: 51 participants enrolled, had > 60 days of EMM data and were included in analyses (median age: 12 years, with a mean of 8.4 months of data). From the first to last month, mean SABA use decreased from 0.68 to 0.25 puffs/day (-0.43, 95% CI: -0.67, -0.20; p<0.001), and mean SABAfree days increased from 25.2 to 28.1 days/month (2.9 days, 95% CI: 1.7, 4.1, p<0.001). 76% of participants improved their number of SABA-free days, while 7.8% maintained and 15.7% worsened. CONCLUSIONS: Analysis demonstrated a statistically significant reduction in SABA use and an increase in SABA-free days among Medicaidenrolled children in a digital asthma intervention in southwest Detroit.