Developing and Evaluating ASTHMAXcel Adventures: A Novel Gamified Mobile App for Pediatric Patients with Asthma.

Background The ASTHMAXcel mobile application has been linked to favorable outcomes among adult asthma patients. Objective We assessed the impact of ASTHMAXcel Adventures, a gamified, guideline-based, pediatric version on asthma control, knowledge, healthcare utilization, and patient satisfaction. Methods Pediatric asthma patients received the ASTHMAXcel Adventures mobile intervention on-site only at baseline (Visit 1), 4 months (Visit 2) and 6 months (Visit 3). The Asthma Control Test (ACT), Asthma Illness Representation Scale-Self Administered (AIRS-SR), Pediatric Asthma Impact Survey (PAIS), and Client Satisfaction Questionnaire (CSQ-8) were used to assess asthma control, knowledge, and patient satisfaction. Patients reported the number of asthma-related emergency department (ED) visits, hospitalizations, and oral prednisone use. Results 39 patients completed the study. The proportion of controlled asthma increased from Visit 1 to Visits 2 and 3 (30.8% vs. 53.9%, p=0.04; 30.8% vs. 59.0%, p=0.02), and largely seen in males. Mean AIRS-SR scores increased from baseline pre to post-intervention, with sustained improvements at Visits 2 and 3 (3.55 vs. 3.76, p=0.0006; 3.55 vs. 3.80, p=0.001; 3.55 vs. 3.99, p=0.0001). PAIS scores improved from baseline to Visits 2 and 3 (43.33 vs 34.08, p=0.0006; 43.33 vs. 31.74, p=0.0001). ED visits and prednisone use significantly decreased from baseline to Visits 2 and 3 (ED: 0.46 vs 0.13, p=0.03; 0.46 vs. 0.02, p=0.02; Prednisone: 0.49 vs 0.13, p=0.02; 0.49 vs. 0.03, p=0.003. Satisfaction was high with mean CSQ ∼30 (out of 32) at all visits. Conclusion ASTHMAXcel Adventures improved asthma control, knowledge, and quality of life, and reduced ED visits and prednisone use with high satisfaction scores.