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Using an Asthma Action Plan iPhone App to Improve Quality of Asthma Care in the Outpatient Clinic

Using an Asthma Action Plan iPhone App to Improve Quality of Asthma Care in the Outpatient Clinic. Naveen Nannapaneni MD, Adeeb Bulkhi MD, Ahmad Hamad MD, Mashkur Husain MD, Alaa Elkhider MD, & Diane Levine MD. The Burden of Asthma.

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Using an Asthma Action Plan iPhone App to Improve Quality of Asthma Care in the Outpatient Clinic

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  1. Using an Asthma Action Plan iPhone App to Improve Quality of Asthma Care in the Outpatient Clinic Naveen Nannapaneni MD, Adeeb Bulkhi MD, Ahmad Hamad MD, Mashkur Husain MD, Alaa Elkhider MD, & Diane Levine MD

  2. The Burden of Asthma • Asthma is one of the most common chronic diseases worldwide with an estimated 300 million affected individuals. • Prevalence increasing in many countries, especially in children. • A major cause of school/work absence. • Developed economies might expect to spend 1-2 percent of total health care expenditures on asthma. Developing economies likely to face increased demand. • Poorly controlled asthma is expensive; investment in prevention medication likely to yield cost savings in emergency care. Global Initiative for Asthma

  3. Asthma Prevalence and Mortality Source: Masoli M et al. Allergy 2004

  4. Asthma Management Goals • Achieve and maintain control of symptoms. • Maintain normal activity levels, including exercise. • Prevent asthma exacerbations. • Avoid adverse effects from asthma medications. • Prevent asthma mortality. http://www.cdc.gov/asthma/speakit/managing_asthma.ppt

  5. Asthma Action Plan • Develop with a physician. • Tailor to meet individual needs. • Educate patient and families about all aspects of plan. • Recognizing symptoms • Medication benefits and side effects • Proper use of inhalers and peak flow meter • Allows patients to manage their asthma on their own. http://www.cdc.gov/asthma/speakit/managing_asthma.ppt

  6. Asthma Action Plan • Guides patients in daily asthma self-management based on either severity of symptoms or % of ideal peak flow. • Stratified into three zones with specific instructions on management in each zone. National Heart, Blood, and Lung Institute Expert Panel Report 3 (EPR 3): Guidelines for the Diagnosis and Management of Asthma. NIH Publication no. 08-4051, 2007.

  7. Objectives of the QI Project • Identify discrepancies in the usage of asthma action plans between specialists and primary care physicians. • Increase primary care physician familiarity with the asthma action plan. • Increase the rate of use of the asthma action plan by primary care physicians. • Improve primary care physician confidence in managing asthma. • Improve quality of care for patients with asthma.

  8. The Project • Performance goal • Implement an iPhone asthma action plan in the Internal Medicine resident clinics to increase the rate of use of the asthma action plan by 20% in 6 months. • Specific • Who: Internal Medicine residents. • What: Increase the use of the asthma action plan. • When: 6 months. • Where: WSUPG Internal Medicine clinics. • Why: Improve outpatient and self-management care of asthmatic patients. • Measurable • Increase the rate of usage of the asthma action plan by 20%. • Achievable • Utilize resident survey to measure pre- and post-intervention usage rates. • Relevant • Asthma is a widely prevalent disease and use of the action plan has been validated as a tool to improve patient outcomes. • Time-bound • 6 months.

  9. The App- Asthma Pal • “Asthma Pal” can now be downloaded from the iOS App Store for free.

  10. Settings Tab • Begin with the ‘Settings’ tab and enter the patient’s ideal peak flow.

  11. Doctor Tab • Under the ‘Doctor’ tab you can select medications, and their frequencies, from a drop down list for each zone of the action plan.

  12. Selecting Medications • For example, selecting Advair and ProAir for the green zone is shown on the next 2 slides… • Note: The app will also send a notification reminder on the phone to take the medicine at the entered interval (this can be cleared in the ‘Settings’ menu).

  13. Selecting Medications cont…

  14. Selecting Medications cont…

  15. Patient Tab • From the ‘Patient’ tab the daily peak flow can be entered and instructions based on zone will be given to the patient.

  16. Patient Tab cont… • These instructions can be followed by the patient to direct asthma self-management.

  17. Patient Tab cont… • The plan could also be emailed to the patient (or to yourself to be printed in the GMAP/4C clinic) if the patient doesn’t have an iPhone.

  18. Patient Tab cont… • There are also links for patients to follow to learn more about asthma and treatment.

  19. THANK YOU! Naveen Nannapaneni MD, Adeeb Bulkhi MD, Ahmad Hamad MD, Mashkur Husain MD, Alaa Elkhider MD, & Diane Levine MD

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