Barbara L. Massoudi, MPH, PhD, BreathEasy Principal Investigator
I recently presented the BreathEasy project at the mHealth Summit, sponsored by HIMSS, as part of a panel on Pulmonary Disease Management. In addition to BreathEasy, one of the other panelists presented on asthma – the M-CHESS project at the University of Wisconsin, Madison. M-CHESS is part of a larger study, The Center for Health Enhancement Systems Studies (CHESS), with a goal to optimize individuals' health behaviors, quality of life, and access to services through research and development of innovative health systems.
Like BreathEasy, M-CHESS was focused on self-management of asthma in inner-city patients using a smartphone. M-CHESS recruited 218 teens and randomized them to two groups – experimental, and control for a study period of 12 months, and then a follow-up of 12 months. All participants were provided with smartphones; the experimental group also received access to the M-CHESS interface, featuring an interactive, Internet-based asthma education program, peer support mechanisms and automated reminders for asthma control medicines and data collection. Researchers used the Asthma Control Test (ACT) to measure how well an individual’s asthma symptoms are being managed. Initial analysis shows a significant effect of M-CHESS on the change in ACT scores across the first 60 days on study (p=.011). On average, the M-CHESS group showed a 2% improvement in ACT score per day of study over the control group. Ongoing analysis will examine whether the drop-off in improvement of symptom control is related to a decline in use of the M-CHESS application and attempt to identify specific subgroups for which M-CHESS may provide the greatest benefit in asthma symptom control.
The two other panelists presented on tuberculosis (TB) projects. The University of San Diego presented on a project that used mobile phones for conducting directly observed therapy via video upload (VDOT) in the US and Mexico. Overall, patients liked using the phone to upload videos, and the compliance rate with timely uploads was high. VDOT represents an additional option to resource intensive traditional, in-person DOT.
Researchers from the University of Utah presented on their TextTB randomized control pilot study which looked at the acceptance and feasibility of a patient-driven mobile phone intervention to support TB treatment adherence in Argentina. Patients were asked to text in when they had taken their medication. Overall, adherence and acceptability of the intervention was relatively high, but mobile phone feasibility issues such as lost messages, modem issues, and running out of SMS credits caused some difficulties for some participants. Further research is needed to evaluate the potential for this method of reporting once these issues have been addressed.
Overall, the panel was very interesting – with findings from all participants providing valuable lessons for future work in mobile health apps. Next, we’ll report on our attendance at the Health IT for the Underserved Conference.
** The mHealth Summit research sessions are archived here – scroll down to Wednesday, December 5, “Pulmonary Disease Management.” Barbara Massoudi’s presentation begins about 50 minutes in.