Asthma is a major and growing public health concern for which there is currently no cure, although symptoms can be controlled. Asthma management is particularly important in pregnant women, as heightened risks of preterm birth, pre-eclampsia, restricted fetal growth, and a cesarean procedure are recognized in these asthma patients.
A multi-disciplinary team of researchers at Monash University’s School of Public Health and Preventive Medicine Centre for Medicine Use and Safety, and Electrical and Computer Systems Engineering departments in Melbourne, Australia, and from other Asia Pacific institutions, developed a new telehealth program called MASTERY (management of asthma with supportive telehealth of respiratory function in pregnancy), which the research team tested in a randomized controlled trial.
The MASTERY program is supported by the Monash Research Impact Fund, and is designed to help pregnant women with asthma monitor their respiratory symptoms regularly and effectively. The program is mediated by a mobile phone app called “Breathe-easy,” used to record asthma symptoms and medication compliance. Breathe-easy data collection is supported by a handheld respiratory device that measures lung capacity and lung function. Data are securely transmitted to a central server, where they can be viewed by participating patients, their healthcare providers, and researchers. The program has proven effective in improving both symptom control and quality of life for asthma patients.
Dr. Johnson George, from the Monash University’s Centre for Medicine Use and Safety, noted that women who are able to achieve effective asthma control during pregnancy have a greater chance of healthy outcomes for both themselves and their babies.
“Asthma control is more effective if the patient takes an active role in its management. The app helps patients manage their asthma through the provision of education, support, remote monitoring, instant feedback and telephone follow ups,” Dr. George said in a Monash news release.
According to the study, which was published in the journal Respirology, lung function accuracy and the validity of data obtained using the handheld respiratory device is comparable to that of data obtained in clinics or respiratory laboratories.
The study, “Telehealth to improve asthma control in pregnancy: A randomized controlled trial,” co-authored by Dr. George with E. Zairina, M.J. Abramson, C.F. McDonald, J. Li, T. Dharmasiri, K. Stewart, S.P. Walker, and E. Paul, notes that better asthma control may be achieved if patients are involved in regular self-monitoring and self-management of symptoms according to a written asthma action plan.
Sponsored by the Asian Pacific Society of Respirology, the study evaluated the efficacy of the MASTERY program, the Breathe-easy Android smartphone application, and its handheld support device in improving asthma control during pregnancy.
Researchers found that at six months gestation, the MASTERY group had better asthma control and asthma-related quality of life compared with a control group receiving usual care. There were no significant differences between groups in lung function, unscheduled healthcare visits, days off work/study, oral corticosteroid use, or perinatal outcomes. Differences between groups were not significant at three months.
Monash’s Centre for Medicine Use and Safety, which conducts multidisciplinary research into preventive, acute and chronic care, emphasized that proper medication management is essential to effective patient treatment plans.
Researchers concluded that telehealth interventions supporting self-management are feasible, and could potentially improve asthma control and asthma-related quality of life during pregnancy, noting that daily remote lung function monitoring makes it easier for healthcare providers to address worsening symptoms. The Breathe-easy app provides users with daily and weekly asthma status feedback, and in cases of poor asthma control status, will recommend changes in treatment and/or advise the patient to contact a healthcare provider.
The investigators suggested that improved management of asthma by way of a telehealth program could also provide other short- and long-term public health benefits, with the potential to influence health policy and improve health outcomes for pregnant women and their babies, as well as benefiting others with asthma and like respiratory conditions. The team believes the program could be made widely applicable for routine clinical use, particularly for those with chronic respiratory conditions.