Virtual coaching program improves asthma outcomes
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Key takeaways:
- The program uses a smartphone app, remote monitoring and education.
- A certified asthma educator conducts the program.
- 95.5% said the program improved how well they understood their asthma.
ANAHEIM, Calif. — Virtual coaching improved symptoms among patients who identified as Black with very poorly controlled asthma, according to a poster at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
“It empowers people,” Leandra Tonweber, PA-C, AE-C, lead asthma coach with Allergy & Asthma Network (AAN), told Healio. “One person even said, ‘This saved my life.’”
Noting that Black patients with asthma experience worse outcomes despite advances in disease management, the AAN developed and offered the free Trusted Messengers Asthma Coaching program.
“We go to under-resourced areas,” Tonweber said.
While visiting health fairs and other events in these areas, Tonweber said, representatives from AAN had attendees fill out questionnaires about their asthma. Patients with moderate to severe asthma who qualified were invited to participate. Information about the program and the qualifying survey were available on the AAN website as well.
“If they qualify, we give them a call,” Tonweber said.
The 6-week program used a customized smartphone self-care app, remote monitoring and self-management asthma education with a certified asthma educator. Topics included the basics of asthma, symptoms, control and action plans.
“I like the basics. What is asthma? What do our lungs do? Because I think we need at least to have an understanding,” Tonweber said.
Education also defined triggers and how to minimize them, how other health conditions may impact asthma, shared decision-making, nutrition, exercise and mental health. Asthma medications and treatment options were another key subject, Tonweber said, because many patients do not understand them. Yet one topic stood out above the others in the education plan, she continued.
“Inhaler technique, inhaler technique, inhaler technique,” Tonweber said. “You probably hear that from lots of different clinicians about how people do it wrong.”
Participants included 158 adults (62% Black), with 44.5% reporting very poorly controlled asthma. Also, 53.5% of the 120 participants who reported income said they earned less than $50,000 a year.
Surveys taken before and after the program indicated a 1.53-day decrease in the number of days where participants reported that they were bothered by their asthma symptoms. Also, the number of days where patients woke up with asthma symptoms fell by 1.08 days, and systemic corticosteroid use decreased by 1.38 bursts.
Incidence of very poorly controlled asthma fell to 43% as well. Plus, participants gave the overall program experience a mean score of 9.14 (standard deviation, 1.51) out of 10, which the researchers said indicated its effectiveness in improving asthma self-management skills.
During the post-program survey, 95.5% of the participants agreed or strongly agreed that the self-care app and the virtual coaching improved their understanding of how asthma impacts their daily lives.
Qualitative comments indicated positive feedback as well, as Tonweber noted how the program changed how participants approached their own physicians, especially as many patients may not know which questions to ask.
“They’ve been able to improve their asthma symptoms, and they’re also more comfortable asking questions and having that communication with their health care provider,” she said. Beyond this study, 256 participants completed the program, and the researchers are now collecting and analyzing their data. AAN then took a break before launching the program’s next round.
“We’ve made some changes, we’ve made some improvements, that we’re really excited about,” Tonweber said.
Materials now include a PowerPoint presentation and a workbook. Also, the platform was upgraded to provide easier access to information to improve interactivity.
“Even though we can see each other and we’re talking, I like to have them ask me questions and talk to me, not just me lecturing them,” Tonweber said. “They can see something in the workbook. It’s really nice to be able to take notes and follow along.”
There are about 35 participants in the program now, Tonweber said, but more are welcome. Some of the current participants came to the program after hearing about it from friends and family who took part in the earlier session.
Tonweber invited physicians to reach out to AAN for more information too. Plus, AAN offers postcards with information and a QR code about the program that physicians can hand out to their patients.
“They can contact us directly if they have questions. They don’t necessarily have to refer a patient, but if they have someone who they really want coached, they’re welcome to email us,” Tonweber said.