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| Name | Class |
|---|---|
| Apple Inc. | INDUSTRY |
| University of California, Irvine | OTHER |
| HealthCore, Inc. | INDUSTRY |
| CareEvolution, LLC |
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The Asthma Digital Study is a virtual, two-arm, randomized, controlled trial that will investigate the impact of digital tools on asthma symptom control, exacerbation frequency, healthcare utilization, and medical expenditures in adults with asthma.
The Asthma Digital Study is a virtual, two-arm, randomized, controlled trial that will investigate the impact of digital tools on asthma symptom control, exacerbation frequency, healthcare utilization, and medical expenditures. Adults with asthma will be randomized to the passive or active arm in a 1:1 ratio.
All participants will be sent two devices, at no cost-an Apple Watch and a Beddit Sleep Monitor. These are publicly available, commercial devices that have not been modified for this study.
The study will be administered largely through a customized version of CareEvolution's MyDataHelps app (the "Study App"). Access to the Study App will be provided to all participants. It will be used to administer informed consent and electronic patient reported outcome (ePRO) measures, and for other study purposes. Only active arm participants will have access to Study App features designed to support asthma self-management. These features include "smart nudges" based on device data, symptom and trigger tracking, evidence-based education, summaries of health metrics gathered from the Apple Watch and Beddit Sleep Monitor, in-app medication refill resources, as well as other resources.
The study duration is 2 years. Participants can keep using the Study App and devices after Year 1, though this is not required. Primary analyses will utilize Year 1 data only. During Year 2, data collection will continue where available, though fewer data will be collected because use of digital tools is not required during Year 2, and health coverage changes may cause loss of access to claims data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Passive | No Intervention | Passive arm participants will be sent two devices, at no cost-an Apple Watch and a Beddit Sleep Monitor. These are commercially available and have not been modified for this study. Participants will be asked to use these devices regularly throughout study Year 1. Participants can optionally continue to use devices during Year 2, if they have met requirements during Year 1 to keep study devices. To be eligible to keep devices, participants must meet pre-specified levels of adherence to study procedures. Access to the Study App will be provided to all participants. It will be used to administer informed consent and electronic patient reported outcome (ePRO) measures, and for other study purposes. However, passive participants will not have access to the Study App features designed to support asthma self-management. | |
| Active | Experimental | Active arm participants will be sent the same devices, also at no cost, and asked to use them in the same manner. Only the active arm will have access to Study App features for asthma self-management, including:
Active participants can, but are not required to, use the Study App in Year 2. Those who choose to may keep using study devices in Year 2, provided they meet requirements to keep devices. These requirements are the same for both arms. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Digital Tools for Asthma Self-Management | Other | Please see description of active study arm. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in asthma-associated expenditures due to emergency department and hospital utilization | Sum of all allowed costs for emergency and hospital care, where asthma is specified as a diagnosis. Costs from the 12 months preceding baseline will be compared to costs from 12 months after baseline. Mean change in costs will be compared across arms. | 12 months before and after baseline |
| Change from baseline in Asthma Control Test (ACT), a validated patient-reported outcome (PRO) measure of asthma symptom control | ACT change among all participants with baseline ACT score suggesting that asthma may be uncontrolled (ACT score of 19 or lower). Mean ACT change will be compared across arms. | Baseline and 12-month time points |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in Asthma Control Test (ACT), a validated patient-reported outcome (PRO) measure of asthma symptom control | Change from baseline among active arm participants with baseline ACT score suggesting that asthma may be uncontrolled (ACT score of 19 or lower). | Active arm only: Baseline and months 1, 2, 3, 4, 5, 6, 8, 10, 12 |
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Inclusion Criteria:
Health insurance coverage through an Anthem, Inc. affiliate.
18-64 years of age
Resident of the United States for the duration of the study
Comfortable reading and writing in English
Owns an iPhone 6s or later
Has been diagnosed with asthma by a provider
1+ emergency department visit in the preceding 24 months with an associated asthma diagnosis, or a combination of factors that might be associated with uncontrolled asthma. Factors include:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jordan Silberman | Palo Alto | California | 94301 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36049674 | Background | Silberman J, Sarlati S, Harris B, Bokhari W, Boushey H, Chesnutt A, Zhu P, Sitts K, Taylor TH, Willey VJ, Fuentes E, LeKrey M, Hou E, Kaur M, Niyonkuru C, Muscioni G, Bianchi MT, Bota DA, Lee RA. A digital approach to asthma self-management in adults: Protocol for a pragmatic randomized controlled trial. Contemp Clin Trials. 2022 Nov;122:106902. doi: 10.1016/j.cct.2022.106902. Epub 2022 Aug 30. | |
| Background | Harris B, Silberman J, Sarlati S, et al. A digital asthma self-management tool reduced emergency visit rates in a Medicaid population. Ann Allergy Asthma Immunol. 2023;131(5):S230-S231. doi:10.1016/j.anai.2023.10.021 | ||
| 40674052 |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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| UNKNOWN |
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| Adherence to Refills and Medications Scale, 7-item version (ARMS-7) |
Validated PRO measure of medication adherence |
| Active arm only: 2 weeks and months 2, 4, 6, 8, 10, 12 |
| Readiness ruler, asthma self-management | PRO measuring confidence in, and perceived importance of, asthma self-management | Active arm only: 2 weeks and months 2, 4, 6, 8, 10, 12 |
| Work Productivity and Activity Impairment Questionnaire 2.0, asthma version | Validated PRO measure of asthma-associated work productivity impairment | Active arm only: Baseline and months 1, 3, 5, 8, 12 |
| Health Confidence Score | Validated PRO measure of confidence in ability to manage general health | Active arm only: Baseline and months 1, 3, 5, 8, 12 |
| Self-reported smoking and e-cigarette use | Adaptations of validated PRO measures | Baseline and month 12 |
| Symptom-free days | Measured using Study App | Active arm only: Months 1-12 |
| Frequency of prescriptions for oral corticosteroids | Months 1-12; Months 13-24 |
| Asthma Medication Ratio | Months 1-12; Months 13-24 |
| Adherence to asthma medications | Proportion of days covered, measured using pharmacy claims | Months 1-12; Months 13-24 |
| Asthma-associated expenditures due to emergency department and hospital utilization | Computed in the same manner as the primary outcome, except that expenditures are computed for Year 2 rather than Year 1. | Months 13-24 |
| Total Asthma-Associated Expenditures | Total allowed costs for all care associated with asthma, including pharmacy and other costs | Months 1-12; Months 13-24 |
| Total Medical Expenditures | Total allowed costs for all claimed healthcare expenses | Months 1-12; Months 13-24 |
| Frequency of unplanned visits for asthma care | Includes acute primary care visits, urgent care visits, emergency visits | Months 1-12; Months 13-24 |
| Study App Engagement Metrics | Frequencies of symptom tracking, trigger tracking, app opens | Active arm only: Months 1-12; Months 13-24 |
| Rates of enrollment in pharmacy auto-refill and home delivery services | Months 1-12; Months 13-24 |
| Derived |
| Silberman J, Sarlati S, Harris B, Lenyoun H, Kaur M, Wagner BG, Bokhari W, Boushey H, Chesnutt A, Sitts K, Zhu P, Willey VJ, Fuentes E, LeKrey M, Alger BL, Muscioni G, Bianchi MT, Bota DA, Taylor TH, Evans M, Amin AN, Stark D, Montanari C, Perry JS, Vian C, Patel M, Poe W, Lee RA. A Digital Asthma Self-Management Program for Adults: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jul 1;8(7):e2521438. doi: 10.1001/jamanetworkopen.2025.21438. |
| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |