Asthma
Conditions
Keywords
asthma, healthcare utilization costs
Brief summary
Propeller Health is collaborating with Dignity Health (formerly Catholic Healthcare West (CHW)) to carry out a focused demonstration project to evaluate the effectiveness and potential cost savings of a deployment of the Propeller Health approach to asthma management. The Propeller Health goal is to bring together the best technology and asthma insight in order to provide Dignity Health with an engaging, data-driven chronic care program to improve asthma management and lower healthcare utilization costs, and to respond to prevention-focused reforms to health insurance laws. This project has been designed to implement and evaluate a data-driven program to improve asthma management and control and lower direct costs through reductions in healthcare utilization. This program has been developed by Propeller Health and has gone through preliminary testing. Each subject participating in the study will receive an Propeller Health device, which captures the time and location of use of inhaled short-acting bronchodilators over a twelve-month period. This information is processed and delivered at regular intervals to the patient and his or her provider to support improved asthma management.
Detailed description
The purpose of the study is to evaluate the impact of the adoption of the Propeller Health system into a healthcare organization, and to provide sufficient information to inform decision making for potential future adopters. The researchers believe that the Propeller Health system has the potential to improve asthma control by providing rescue inhaler actuation data and tailored asthma management tips to patients with uncontrolled asthma, and rescue inhaler actuation data to their providers. Improvements in asthma control should be reflected in reductions in healthcare utilization for asthma, and potentially for general healthcare utilization. Reductions in utilization would result in lower healthcare costs. The study has been designed to capture data on individual subject asthma control, and changes in utilization and costs over a one-year introduction period.
Interventions
DEVICEPropeller Health System (formerly Asthmapolis System)
The Propeller (formerly Asthmapolis) system works through the provision of information to patients and their providers. With the Propeller (formerly Asthmapolis) device in place, each actuation of a patient's rescue inhaler is recorded with an automatic time stamp; in many circumstances, the location at which the device is actuated is also captured and recorded. Actuation data are then securely transmitted to Propeller (formerly Asthmapolis) where events and an assessment of asthma control can be viewed in secure online interfaces. The information is also compiled into individual reports that are returned to the patient and his or her provider. Patients also receive customized suggestions for asthma management based on their actuation history.
Sponsors
California HealthCare Foundation
Reciprocal Labs
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Provider diagnosis of asthma (ICD9 493.xx); * At least one healthcare utilization event in CHW within last 12 months; and * Prescription for Short Acting Beta Agonist (SABA) at study intake.
Exclusion criteria
* Subject is under the age of 5 at the beginning of the study; * Subject does not speak either English or Spanish; * Subject does not have access to the Internet or email to receive reports; and * Subject has substantial co-morbidity (provider diagnosis of COPD
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mean SABA Use | Change in mean SABA use over the course of 12 months | Mean SABA use as measured by the Propeller Health sensor during the period of intervention (12 months). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in the Proportion of SABA-free Days From Baseline to 12 Months | Baseline to 12 months | Evaluate the change in the proportion of SABA-free days from baseline to 12 months |
Countries
United States
Participant flow
Recruitment details
Participants were recruited between April 2012 & June 2013 via an asthma registry, community outreach efforts, and provider referrals.
Participants by arm
| Arm | Count |
|---|---|
| Intervention Group Intervention group (IG) participants received access to and feedback from the Propeller Health System (formerly Asthmapolis System).
Propeller Health System (formerly Asthmapolis System): The Propeller (formerly Asthmapolis) system works through the provision of information to patients and their providers. With the Propeller (formerly Asthmapolis) device in place, each actuation of a patient's rescue inhaler is recorded with an automatic time stamp; in many circumstances, the location at which the device is actuated is also captured and recorded. Actuation data are then securely transmitted to Propeller (formerly Asthmapolis) where events and an assessment of asthma control can be viewed in secure online interfaces. The information is also compiled into individual reports that are returned to the patient and his or her provider. Patients also receive customized suggestions for asthma management based on their actuation history. | 250 |
| Control Group Control group (CG) participants were outfitted with sensors from the Propeller Health System, but did not receive feedback. | 245 |
| Total | 495 |
Baseline characteristics
| Characteristic | Intervention Group | Control Group | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 74 Participants | 75 Participants | 149 Participants |
| Age, Categorical >=65 years | 13 Participants | 12 Participants | 25 Participants |
| Age, Categorical Between 18 and 65 years | 163 Participants | 158 Participants | 321 Participants |
| Sex: Female, Male Female | 145 Participants | 140 Participants | 285 Participants |
| Sex: Female, Male Male | 105 Participants | 105 Participants | 210 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 250 | 0 / 245 |
| other Total, other adverse events | 0 / 250 | 0 / 245 |
| serious Total, serious adverse events | 0 / 250 | 0 / 245 |
Outcome results
Primary
Change in Mean SABA Use
Mean SABA use as measured by the Propeller Health sensor during the period of intervention (12 months).
Time frame: Change in mean SABA use over the course of 12 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Change in Mean SABA Use | -0.41 mean puffs per day | Standard Deviation 0.69 |
| Control Group | Change in Mean SABA Use | -0.31 mean puffs per day | Standard Deviation 0.75 |
Secondary
Change in the Proportion of SABA-free Days From Baseline to 12 Months
Evaluate the change in the proportion of SABA-free days from baseline to 12 months
Time frame: Baseline to 12 months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Group | Change in the Proportion of SABA-free Days From Baseline to 12 Months | 21 % Change in proportion of SABA-free days |
| Control Group | Change in the Proportion of SABA-free Days From Baseline to 12 Months | 17 % Change in proportion of SABA-free days |