Systematic Review of mHealth Applications that Interface with Inhaler Sensors in Asthma

Abstract Background A better understanding of outcomes associated with mobile health (mHealth) apps for asthma self-management that pair with inhaler sensor technology is needed for clinicians to practice evidence-based medicine. Objective To evaluate the effects of mHealth apps that integrate with an inhaler-based sensor on outcomes of patients with asthma. Methods We performed a systematic review in GooglePlay and Apple App stores for consumer-facing mHealth apps for asthma management that pair with an inhaler-based sensor. We then searched for evidence evaluating these apps via PubMed and Cochrane Central (January 2007-May 2020), bibliographies on product websites, and www.clinicaltrials.gov . We included studies in patients with asthma evaluating apps discovered in the app stores on adherence or a health outcome of interest, and qualitatively summarized evidence. Results We identified six mHealth apps and screened 2594 citations for evidence on these apps; 7 studies of two apps were included. Interventions modestly improved maintenance inhaler adherence and reduced rescue inhaler use but did not impact Asthma Control Test scores. Effects on exacerbations, quality of life, and pulmonary function were not evaluated in these studies. Conclusion The current literature evaluating mHealth apps paired with inhaler-based sensors focuses on a small number of available products and has limitations in quality. Positive effects on rescue inhaler use, inhaler adherence, and patient satisfaction were found. However, more comprehensive evaluation of products and their impact on health outcomes is needed before clinicians and patients can weigh the benefits against resources needed to adopt these technologies.