Abstract

Significant indirect healthcare costs are related to uncontrolled asthma, including productivity loss. Days with short-acting beta-agonist (SABA) use is associated with symptom-related disruptions at work, home, and school. Digital self-management platforms may support fewer days with SABA medication use and may reduce symptom-related disruptions.

Introduction

Poorly controlled asthma, representing ~60% of children and adults with asthma in the United States¹, can result in significant healthcare costs and lost productivity at school, work, and home, of which the latter is estimated to cost $3B annually². A similar loss in productivity is also observed globally³. Digital health solutions have shown promising results in promoting improved clinical outcomes and reducing healthcare resource utilization in asthma^4,5, but few studies have explored its potential to assess productivity with passively-collected electronic data.

Electronically-recorded short-acting beta-agonist (SABA) medication use may serve as an important objective determinant of asthma control, as shown in Anderson et al.⁶ who found that electronically-recorded SABA usage was correlated with self-reported SABA use as captured by question 4 of the Asthma Control Test (ACT). Further, electronic tools like electronic medication monitors (EMMs) could reduce recall bias associated with self-reported symptom surveys like the ACT or the Asthma Control Questionnaire. We hypothesized that electronically-recorded days without use (“SABA-free days”, SFD) may also act as an important objective proxy for productivity. As such, this study aimed to understand the relationship between electronically-captured SFD and self-reported productivity, representing symptom-related disruptions at work, school, and home from question 1 of the ACT, and how these outcomes change over time when enrolled in a digital self-management platform.

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