Assessing the impact of a remote digital coaching engagement program on patient-reported outcomes in asthma

ABSTRACT

Background: Low adherence and poor outcomes provide opportunity for digital coaching to engage patients with uncontrolled asthma in their care to improve outcomes. Objective(s): To examine the impact of a remote digital coaching program on asthma control and patient experience. Methods: We recruited 51 adults with uncontrolled asthma, denoted by albuterol use of >2 times per week and/or exacerbations requiring corticosteroids, and applied a 12-week patient-centered remote digital coaching program using a combination of educational pamphlets, symptom trackers, best peak flow establishment, physical activity, and dietary counseling, as well as coaches who implemented emotional enforcement to motivate disease self-management through telephone, text, and email. Baseline and post-intervention measures were quality of life (QOL), spirometry, Asthma Control Test (ACT), Asthma Symptom Utility Index (ASUI), rescue albuterol use, and exacerbation history. Results: Among 51 patients recruited, 40 completed the study. Eight subjects required assistance reading medical materials. Significant improvements from baseline were observed for Patient-Reported Outcomes Measurement Information System mental status (p = 0.010), body weight, and outpatient exacerbation frequency (p = 0.028). The changes from baseline in ACT (p = 0.005) were statistically significant but did not achieve the pre-specified minimum clinically important difference (MCID), whereas for ASUI, the MCID and statistical significance were achieved. Spirometry and rescue albuterol use were no different. Conclusion: A patient-oriented, remote digital coaching program that utilized trained health coaches and digital materials led to statistically significant improvement in mental status, outpatient exacerbations, body weight, and ASUI. Digital coaching programs may improve some outcomes in adults with uncontrolled asthma.

KEYWORDS:

• Alternative medicine
• education
• management/control
• quality of life
• treatment

Acknowledgements

The authors gratefully acknowledge the following individuals for their assistance in the above study: Ana Quinn MBA and Gretchen Sanders for their roles in project management; and Sean Bowman MPH for his assistance with the preparation of the submission packet.

Declarations of interest

The authors declare the following interests: Dr. Rasulnia, Mr. Burton, and Mr. Ginter are employees of Pack Health, LLC: a for-profit organization that uses the evaluated intervention in the service they provide. Drs. Wang, Pleasants, Green, and Lugogo report no conflicts of interest.

Funding

This study was funded by a grant from Genentech, LLC.