This article first appeared in the St. Louis Beacon, Dec. 11, 2012 - This year, the Asthma and Allergy Foundation of America ranked St. Louis as the seventh worst city in the U.S. for people living with asthma. Saint Louis University professor Mark Gaynor, along with a team of researchers from SLU, Harvard University and the St. Louis College of Pharmacy, is working to make managing asthma easier for people living in St. Louis and all over the world.
Thanks to a $93,000 gift from Google and a $25,000 presidential research grant awarded to Gaynor by SLU, the team of researchers is working to create a smartphone application with a data-collecting infrastructure to recognize and address factors that affect asthma.
“We wanted to do something on smartphones, and we realized that asthma was a really good chronic condition to do in St. Louis because a lot of people are affected by it, it’s relatively easy to treat, we know what to look for,” Gaynor said.
The app will warn users of potential asthma triggers through a direct messaging system. Data from the app will be recorded in electronic health records to aid medical professionals in the treatment of asthma. The intent is to help asthma sufferers better manage their chronic condition and to help health-care providers receive more accurate data about what may be contributing to asthma problems.
“It will be a combination of a smartphone app and background infrastructure. For example, we want to collect admissions from emergency rooms for asthma. Then, I want to collect environmental data. What correlations can we make from that? I also want to collect information about you, personally, what triggers your asthma,” Gaynor explained.
The hope is that the combination of these different types of information could indicate what kind of conditions set off asthma symptoms. The app can update an individual's data and alert particular patients to be mindful of their asthma and take their medication, based on the weather or their current location. For example, the app might send a message that the users should not exercise outside today, or that they should carry their medication when they exercise.
Dr. David Schneider, a member of the research team and professor of family and community medicine at SLU, hopes that the app will be user-friendly and personalized to suit patients’ needs.
“We would like to be able to personalize [the app] in messaging back to the patient,” Schneider said. “It has to be relevant and useful; otherwise it wouldn’t be necessary.”
This type of application could prove to be especially pertinent to St. Louis residents. Asthma Free St. Louis, a community program sponsored by the St. Louis Department of Health, found asthma is the fourth leading cause of death in the St. Louis area. The department also reported that children’s asthma rates in St. Louis are twice the national average, and death rates in this population are three times the national average.
Mary Barron, a nurse practitioner and SLU researcher working with Gaynor, emphasized the importance of working with both medical professionals and patients to determine what kind of app would be most useful.
“We did focus group research first,” Barron explained. She said the purpose of the focus groups was to determine what kind of practical features patients would like and what kind of medical history nurses and doctors would want to know.
Erica Pearce, a clinical pharmacist and assistant professor at the St. Louis College of Pharmacy, is primarily concerned with how to present asthma medications in the app.
“There is quite a bit of data that suggests that the vast majority of the population do not use their inhalers correctly…if you don’t get that timing right and breathing correct, it won’t work,” Pearce explained. She said that the app will eventually include videos that show people how to properly use an inhaler.
Researchers at Harvard are doing a lot of the technical work for the app, including building the infrastructure and writing code.
The app will use Google Maps to overlay the user’s geographic location and show what areas are better or worse for their asthma, said Gaynor. The GPS system can also be used to track weather and the effects it will have on a user’s asthma.
A peak-flow meter is part of the app. The meter will measure the user’s lung capacity and automatically send the information to an electronic health record.
“We believe that if you want to get people to do things like this, then you need to make it easy for them to do,” Gaynor said. App users "can keep track of what they’re doing, their activity levels, peak- flow and basically have a snapshot of where they are at any given time.
“This [app] is one way to help people do self-management. Because of the growing cost of health care, that’s what you need…Most of the health-care costs are really for chronic conditions these days, and if you can get people to manage their own chronic conditions, you save money and they have better outcomes. So it’s a win-win situation,” Gaynor explained.
The hope is that if this app is successful, similar apps can be designed to target other chronic illnesses.
“Ultimately, we want this to be for all chronic conditions. We’ve seen evidence that suggests that 80 percent of dealing with chronic conditions is the same,” said Gaynor.
For now, data collection and application building will continue. The research team debuted a basic prototype of the application at their most recent meeting. “We’re putting the pieces together,” said Schneider.
Elizabeth Bartek is a Beacon intern.