Online Program

Louisville asthma data initiative - a municipal digital health program to improve self-management and public health surveillance of asthma

Tuesday, November 5, 2013 : 11:10 a.m. - 11:30 a.m.

David Van Sickle, PhD, Asthmapolis, Madison, WI
Ted Smith, PhD, Economic Growth and Innovation, Louisville Metro Government, Louisville, KY
Meredith Barrett, PhD, Propeller Health, San Francisco, CA
BACKGROUND In 2012, Asthmapolis and the City of Louisville partnered to establish a data-driven, vertically integrated, asthma management program in Louisville, KY designed to improve the management of asthma among city residents and develop new data sources to strengthen public health efforts to control the disease. We report interim results summarizing the effect on asthma control.

METHODS Residents of the Louisville Metro with physician-diagnosed asthma are enrolled at participating retail pharmacies and clinics where they receive at no-cost small electronic inhaler sensors that track the frequency of use of their rescue and controller medications. After an initial month-long monitoring period, participants receive access to smartphone and web-based applications designed to support and encourage appropriate self-management. Paired sample t-tests were used to examine differences in asthma-free days and rescue inhaler use between control and intervention periods.

RESULTS As of January 2013, a total of 238 people had enrolled; median time in study was 46 days (IQR: 24-81 days). On average, participants experienced a mean of 21 asthma-free days (or 9 days with inhaler usage) in the initial 30 day control period and used their rescue inhalers a mean of 18.5 times. In the subsequent 30 days, the mean number of asthma-free days increased by 3 to 24 (or 6 days with rescue inhaler usage) (p=0.0001) and use of rescue inhalers decreased to 13 events (p=0.0009). In general, people with more inhaler usage in the control period had bigger reductions in inhaler use in the second month.

CONCLUSIONS Measures of the day-to-day burden and management of asthma suggest that digital tools used to capture an ongoing assessment of asthma control and provide targeted asthma education have reduced the burden of asthma morbidity. Public health dashboards and reports will provide an integrated view of the real-time burden of asthma and relevant environmental information.

Learning Areas:

Chronic disease management and prevention
Environmental health sciences

Learning Objectives:
Describe the potential for digital health tools to support more appropriate self-management of asthma, while enabling a novel, bottoms-up approach to public health surveillance.

Keyword(s): Asthma, Community-Based Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Meredith Barrett, PhD, has over 15 years of experience in environmental science and health research, and has studied the impacts of environmental change on both infectious and chronic disease. She was a Robert Wood Johnson Foundation Health & Society Postdoctoral Scholar at the University of California Berkeley and UC San Francisco from 2011-2013, where she first collaborated on this Louisville project.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Propeller Health Chronic respiratory disease Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.