myAirCoach: mHealth assisted self-management in patients with uncontrolled asthma, a randomized control trial

Background: Mobile health (mHealth) could play an important role in assisting patients self-managing their asthma. Therefore we developed the myAirCoach mHealth system to aid self-management. We aimed to assess the effect of the myAirCoach system in addition to usual care on asthma control. Methods: In a randomized controlled trial in the Netherlands we included 30 patients with uncontrolled asthma using a staggered enrolment with 3-7 months follow-up. Patients received either 'usual care' or 'usual care + self-management support via 'myAirCoach''. In addition, we performed a 3-month before-after study in 12 patients in the UK. Asthma control was measured with the Asthma Control Questionnaire (ACQ), with a minimal important difference (MID) of 0.5. Secondary outcomes were exacerbation rate and quality of life, measured by the mini Asthma Quality of Life Questionnaire (mAQLQ) with a MID of 0.5. The myAirCoach system consisted of an app, myAirCoach inhaler add-on, indoor air-quality monitor, physical activity tracker, home spirometer and FeNO device. Results: Asthma control improved in the Dutch intervention group compared to controls (ACQ-difference 0.70, p=0.006). A total of 4 severe exacerbations occurred in the intervention group compared to 12 in the control group (hazard ratio 0.22, 95%CI 0.07-0.71, p=0.011). Also quality of life improved significantly (mAQLQ difference 0.53, p= 0.04). In the UK patients, asthma control improved by 0.86 compared to baseline (p=0.007) and quality of life was 0.16 higher (p=0.64). Conclusion: The myAirCoach mHealth self-management system provides an improvement in asthma control and quality of life and a reduction in asthma exacerbation.