Let’s examine an application for our asthmatics

There are a number of health-related applications designed to help patients manage their diseases. The applications vary in their value and usefulness to patients. A short review of this trend was published at Scientific American. One application designed for asthmatics seems promising. Hopefully, this is the first of a number of applications to help our patients with lung disease.

The application, titled AsthmaMD™, is written by Dr. Sam Pejham, a pediatrician in Northern California. The application is currently only available for the Apple® iPhone™, iPod Touch™ or iPad™. The application is available at no charge.

The goal of the app is to make saving quality of life and peak flow measurements easy and to provide feedback to the user of how they are doing. It also gathers anonymous asthma data that might help researchers. The data is sent to a Google database and includes severity of asthma attacks, triggers, time, date and location. Users must opt-in to allow data to be shared.

The application can track multiple asthmatics and collects height, age and medication information. It also allows users to enter their specific asthma triggers.

After creating a user profile, it is easy to enter peak flow readings using a three digit selector wheel. One problem with peak flow is that it uses published prediction data for an asthmatic rather than their personal best. The result of this for many asthmatics is that on their best days, the app will tell them they are doing poorly. Once the peak flows have been entered, it is easy to display a graph of values at various time scales.

Medication is also a little quirky. A single input screen is used for inhaled medications and does not reflect the various delivery systems. As an example, all dry powder inhalers and oral medications require the user to enter a number of puffs per day rather than actuations, tablets or capsules. Further, Albuterol has no provision for prn use, so is entered as regular use. This is less of a problem than it might seem, as each time one records symptoms and peak flow, and the use of medication is entered even though it may be regularly scheduled. The user can go back and enter missing data for earlier days.

A diary is available to note user symptoms, triggers that may have been encountered in addition to medication use and peak flow. The diary can be reviewed to follow exacerbations and the data can be sent to the user’s physician. The report comes as an HTML page with the peak flow graph followed by the diary data, which includes date, time, zone (green, yellow, red), peak flow reading, symptoms, medications used and triggers encountered. The data other than the peak flow graph can be copied as text and potentially placed in an electronic medical record.

This application looks promising and will likely improve over time. More information can be found at www.asthmamd.org, as well as in the Apple app store.