L24:
Implementing Health Care Research Technology to Improve Asthma Management
Monday, March 5, 2018
South Hall A2 (Convention Center)
Peter J. Cvietusa, MD FAAAAI
Rationale:

Research looking at the use of technology to improve asthma adherence and outcomes has shown promise. Few studies have looked at the implementation of such research on larger asthma populations.

Methods:

A Speech Recognition (SR) program was implemented for the total KPCO patient population of 480,142, of which 36,356 had asthma. To be included in this analysis, patients had to have a diagnosis of persistent asthma, filled 1 or more ICS prescriptions in the prior 6 months, and remain continuously enrolled with Kaiser Permanente for a two-year period (10/23/12-10/23/14). We compared adherence and exacerbation events one year prior to the intervention and one post intervention for 4,510 adults ages 19-64. Documentation of an exacerbation event was defined as a hospitalization, emergency room visit, or course of prednisone where asthma was the principal diagnosis.

Results:

Patient adherence, defined as portion of days covered (PDC), improved from 39.5% to 41.1% (P-value: 0.0001). There was no difference in asthma outcomes. The implementation of the SR program was found to have had a significant impact when evaluated using the dimensions of the RE-AIM framework. The initial cost of developing the SR system using internal resources was $11,000. Using an external vendor, it would have cost $24,000.

Conclusions:

We showed that an SR reminder system was relatively easily adopted and implemented in our organization, at a low cost, that was easy to maintain and allowed us to reach a greater population in an effort to improve asthma medication adherence.