A unique cell phone application that targets minority adolescents who have asthma aims to reduce exacerbations of the condition and emergency department (ED) visits.
In the new 3-month-long study, each of the 14 adolescents (age, 11 to 16 years) receives a smartphone preloaded with an application that uses a reward system to encourage them to take their daily asthma controller medications.
“This is a new approach to engage teenagers and change behavior through the use of positive feedback via accountability and persuasive visualization,” Giselle Mosnaim, MD, Assistant Professor of Allergy and Immunology at Rush University Medical Center in Chicago, told ConsultantLive.
Across Illinois, there were 1.9 million asthma-related ED visits and 479,300 asthma-related hospitalizations in 2009. From 2001 through 2009, asthma rates rose the most among African American children compared with Hispanic and white children.
“It is very challenging to motivate inner-city adolescents to take their daily asthma controller medications,” said Dr Mosnaim. “Teens spend a huge amount of time interacting with technology. We believe that leveraging their existing use of technology will be a great way to engage adolescents and motivate them to take their medication.”
The study, which began on June 6, provides the inner-city adolescent patients who have asthma with immediate rewards when they take their medication appropriately. Their controller medication is fitted with a sensor that sends a signal to the smartphone application automatically when a dose is taken.
The application and device were created by faculty and student collaborators in computer science, electrical engineering, communications, and art and design at the University of Illinois at Chicago Electronic Visualization Laboratory.
“The smartphone is equipped with a Bluetooth application that records every time the inhaler is used,” Dr Mosnaim said. “This connection gives us participants’ times and dates, locations in latitude and longitude, as well as ambient air pollution and pollen levels from the National Allergy Bureau and Environmental Protection Agency every time they take a puff.”
Dr Mosnaim monitors their real-time, medication-taking behavior via the data collected by the electronic dose counter, processed by the smartphone asthma application, and sent to the secure server. She and her colleagues may provide participants instant feedback by sending them text or e-mail messages.
“We can remind them to refer to their asthma action plan written by their personal physician on what steps to take in case of an asthma exacerbation,” she said.
The patients also get immediate positive reinforcement when they take the dose within the correct time window. “Every time they take the entire dose in the correct time window, they get to score baskets in a virtual basketball game, and they earn 50 cents that they can use at the Googleplay store to purchase music, apps, movies, or television shows,” Dr Mosnaim said.
So far, the patients “seem excited to have a phone with the asthma app,” Dr Mosnaim said. “Daily inhaled corticosteroid medication is the gold standard treatment to control persistent asthma. We need to motivate teens to take their daily inhaled corticosteroid medications and better manage their asthma.”
If the technology motivates the patients to be more accountable, then Dr Mosnaim hopes to do a randomized controlled trial with at least 100 teens to further prove its effectiveness.