Not One More Life: Trusted Messenger Telehealth Asthma Coaches Program

Abstract

Background:

A disproportionate burden of mortality and morbidity exist in underrepresented adult minorities diagnosed with asthma, COPD, and COVID-19. To address this burden, a community outreach program incorporated trusted messengers and met people in their community and used validated respiratory health screening tools to stratify those at risk for uncontrolled disease.

Methods:

This interventional prospective cohort study invited adults age 18 and older to participate. During the community outreach program participants had opportunity to complete the AIRQ and CAPTURE Tools. Those who were identified as at-risk based on the score of 2 or higher were invited to participate in the Not One More Life Trusted Messengers Telehealth Asthma Coaches program. This program was a 16-week intervention with asthma education, remote respiratory monitoring using pulse oximetry, spirometry, and breath monitoring with access to the free self-care app to record asthma symptoms, medications, moods and to complete related health surveys. Descriptive statistics were used to summarize patient quality of life, symptom scores, and app engagement pre-post intervention using paired samples t-test and repeated measures ANOVA for those scores reported across 3 time points. This study was approved by the Institutional Review Board.

Results:

Of the 277 participants, 26.4% enrolled in the Telehealth Asthma Coaches program and 79% of participants had uncontrolled asthma and on average participants had 2.5 comorbid conditions. On average, participants report lower levels of difficulty in their personal life post intervention, specifically there was a statistically significant difference in mean scores concerning the way I look (t (10) = -2.653, P < .005). Asthma experience biweekly symptom survey scores had a statistically significant difference across 3 time points in mean number of days participants were bothered by their asthma symptoms (cough, wheeze, shortness of breath, chest tightness, sputum production). There was a statistically significant difference across 3 time points in the mean number of days participants used their quick relief inhaler. A post hoc test revealed the number of days participants used their medication reduced by an average of 2.63 days between week 0 and week 12 of the study (F (2,24) = 3.840, P < .05).

Conclusions:

The combination of the Telehealth Asthma Coaches program with digital disease management and monitoring may have played a vital role in the asthma management in this patient population.