Respiratory RWE during COVID-19

OBJECTIVES: Minority populations bear a disproportionate burden of the morbidity, mortality and prevalence of respiratory illness, including asthma, COPD and COVID-19. The objective of the Not One More Life, Trusted Messengers pilot program was to address health inequalities, increase access to health information and screenings for disadvantaged individuals with respiratory disease, improve long-term health outcomes among participants with asthma and COPD, and evaluate the impact of a digitally enabled program on respiratory outcomes.

METHODS: Screening events were conducted with community churches and targeted digital marketing to reach underserved communities. Eligibility was based on underlying respiratory conditions measured using "Asthma Impairment and Risk Questionnaire" and "COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease & Exacerbation Risk" (CAPTURE) questionnaires and fractional exhaled nitric oxide (FeNO) to engage in 16 weeks of remote monitoring. Participants used the Health Storylines platform to receive virtual coaching sessions and provide data through direct entry and synced devices. The impact of the intervention on asthma outcomes and patient satisfaction was measured using changes in symptom severity from baseline, bi-weekly questionnaires, spirometry, peak flow, pulse oximetry, breath biomarkers, use of digital inhalers and digital engagement analytics.

RESULTS: The program screened over 1,200 patients and enrolled 72 participants from an eligible group of 156 patients. At the conclusion of the study, the participants demonstrated improved quality of life, improved lung function, reduced frequency of rescue inhaler use, and high participant satisfaction. In addition to free text describing their impression of the intervention, participants also reflected on the impact of the COVID-19 pandemic on health related quality of life and access to care.

CONCLUSIONS: The findings suggest that a combination of virtual coaching and digital disease management can play a needed role in the future of asthma management and research to improve symptom control, medication adherence and patient satisfaction