Meyonna Cosey often sat on the sidelines in gym class. Many times, she skipped outings with her friends. The 14-year-old from Chicago said she frequently felt isolated and lonely because she didn’t know when or where an asthma attack would strike.
“The last time I had an asthma attack, I couldn't talk at all. I was gasping for air; it was just very, very scary,” Meyonna said. “I just want to get better.”
Meyonna isn’t alone. She and her 7-year-old brother, Brandon, have experienced severe asthma for most of their lives, posing a challenge for their mother to know how to best protect them from sudden symptoms that often arise with little or no warning.
“Weather changes, climate changes, small triggers,” said McKayla Kline, their mother. “It can be tiresome as a parent.”
It’s why McKayla enrolled her children in a first-of-its-kind asthma study to test a “smart inhaler” that uses Bluetooth® technology and mobile apps to send real-time data back to parents and medical providers to help them monitor the usage.
Most children with asthma take two inhaler medications — a daily “controller” medication of corticosteroids to prevent exacerbations and a rescue inhaler for breathing troubles. However, some families struggle to manage multiple medications.
“Often times it's very confusing to families which inhaler is which and what they're supposed to do with them,” said Ruchi Gupta, M.D., a professor of pediatrics at Northwestern University Feinberg School of Medicine and a practicing physician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “As physicians, we are unable to really monitor how patients are using their medications. This limits our ability to support their asthma management. Our goal is to see how we can use technology best to help us improve care for our children with asthma.”
UnitedHealthcare organized the study in collaboration with Dr. Gupta, Northwestern University and five Chicago-area pediatric clinics. More than 250 Chicago-area children between 4 and 17 years old with moderate to severe asthma participated in the “Improving Technology-Assisted Recording of Asthma Control in Children” (iTRACC) study over the course of one year.
If a child in the study missed four days in a row of their prescribed medication, or if they used a rescue inhaler more than four times in one day, the connected device would send an automatic alert to the family’s health care provider to intervene.
In Chicago, the prevalence of asthma in children under 18 is 14%, which is higher than the national rate of 8-10%. In specific neighborhoods and racial groups, asthma rates can soar up to 44% of children, according to Dr. Gupta’s research published in the Journal of Allergy and Clinical Immunology.
In addition, African-American children in the city have almost double the rates of asthma compared to white children, Dr. Gupta said.The disease is higher among children who live in poverty or urban environments, where access to primary care is often limited. Asthma is one of the top reasons kids are hospitalized, admitted to emergency rooms or are absent from school, Dr. Gupta added.
For Deneen Vojta, M.D., a pediatrician and senior vice president of innovation, research and development for UnitedHealth Group, pilot programs like this can help identify barriers to care and better understand how connected devices can be used to improve treatment plans for people with chronic conditions, such as asthma.
“The future of digital health innovation is tantalizing, with a multitude of connected devices providing personalized feedback to help people improve their health,” said Dr. Votja, who specializes in pediatric well-being programs. “We are already starting to see the benefits of these advances, helping health care professionals gain access to tangible data to help them more effectively counsel patients and encourage them to more closely follow recommended treatments.”
The results of the asthma study are expected to be published in a peer-reviewed journal in the near future.
As for Meyonna, she’s about to begin her eighth grade year, and now has much more confidence that she can participate in the activities she loves, including dancing and painting.
“I feel amazing; I'm just happy that I can do a lot more than I could,” she said. “This study is the best because I'm going to be better. Asthma's not going to keep me down forever, so I just keep that positive mindset.”