Mobile app improves shared decision-making experience in asthma care

PHOENIX —Use of a mobile app that facilitates shared decision-making in asthma treatment was associated with high patient satisfaction, according to a presentation at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

“Most shared decision-making (SDM) tools for asthma focus mainly on choosing medications and not much else,” Deborah L. Lee, MD, an allergy fellow at University of Michigan, said during the presentation.

“We hypothesized that an electronic shared decision-making app tailored to patients’ concerns can improve the quality of shared decision-making and patient satisfaction,” Lee continued.

The study involved 73 adults (women, n = 56) with persistent asthma seen at an academic allergy clinic randomly assigned to a control group (n = 32) or an experimental group using the Asthma SDM app (n = 41).

Patients in the experimental group used the app before their clinical visit to answer questions about their medication, nonmedication and COVID-19 concerns. These results were shared with the allergy provider about a week before the visit.

“The app prompts patients to indicate concerns about their asthma, such as exercise-related concerns, concerns regarding asthma triggers and frequent symptoms,” Lee said. “They also could indicate medication-related concerns, such as questions about side effects, how to use medications and questions about adherence.”

Additionally, patients could use the app to indicate COVID-19 concerns such as use of the vaccine, signs and symptoms of the virus, and risks for asthma exacerbation with the disease.

“Patients were also able to indicate how much involvement they wanted to have in shared decision-making. They could indicate if they preferred more information vs. big picture vs. preferring that the doctor chooses the best asthma treatment,” Lee said.

Patients could indicate any other concerns that they have about the goals of their visit as well, Lee added.

“We found that patients can be more concerned with outcomes such as the ability to exercise or have symptoms and stay out of the emergency room, which are not just purely related to asthma medications,” Lee said. “An asthma shared decision-making app that could ask those comprehensive questions could be helpful.”

After the visit, all the participants completed a nine-item SDM-Q-9 instrument, scored from 0 to 100. The patients in the control group who completed the instrument (n = 26) had an average score of 79.8 ± 23.5%, whereas those in the experimental group (n = 35) had an average score of 87.4 ± 9.7% (P = .045).

The participants also completed a five-item patient satisfaction survey, scored from 0 to 25, after the visit. The control group (n = 23) had an average score of 21.7 ± 3.9, and the experimental group (n = 32) had an average score of 23.3 ± 2.1 (P = .029).

According to Lee, patients who used the shared decision-making app were more likely to report greater satisfaction with their doctor and treatment decisions. A month after the visit, participants also were asked about their perception of asthma control. Participants from the control group (n = 23) reported an average score of 4.22 ± 0.61, and participants from the experimental group (n = 33) reported an average score of 4.19 ± 0.69, indicating no difference between the groups.

“We found that the use of a patient-centered electronic shared decision-making app was associated with greater patient satisfaction with shared decision-making and also with perception of quality of shared decision-making,” Lee said.