Download Source: Masoli M et al. Allergy 2004

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
 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
Asthma Prevalence and Mortality
Source: Masoli M et al. Allergy 2004
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
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
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.
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.
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.
The App- Asthma Pal
 “Asthma Pal” can now
be downloaded from
the iOS App Store for
free.
Settings Tab
 Begin with the ‘Settings’
tab and enter the
patient’s ideal peak
flow.
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.
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).
Selecting Medications cont…
Selecting Medications cont…
Patient Tab
 From the ‘Patient’ tab
the daily peak flow can
be entered and
instructions based on
zone will be given to the
patient.
Patient Tab cont…
 These instructions can
be followed by the
patient to direct asthma
self-management.
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.
Patient Tab cont…
 There are also links for
patients to follow to
learn more about
asthma and treatment.
THANK YOU!
Naveen Nannapaneni MD, Adeeb Bulkhi MD, Ahmad Hamad MD,
Mashkur Husain MD, Alaa Elkhider MD, & Diane Levine MD