# Larger quality-of-life gains with an asthma support app: a randomised controlled trial

## TL;DR

A Chatbot-based asthma app improved patients' quality of life more than standard education over six months.

## Contribution

A Chatbot app with GINA guidelines and pulmonologist access improved asthma patients' quality of life.

## Key findings

- Chatbot group showed greater improvements in Asthma Quality of Life Questionnaire (AQLQ) scores.
- Baseline asthma control and spirometry metrics were similar between groups.
- No significant differences in ACQ5 or spirometry changes between groups.

## Abstract

Smartphone applications present an opportunity to offer timely and personalised care to asthma patients. The aim of the study was to determine whether a Chatbot-based application for asthma patients providing educational content and direct access to pulmonology staff improves quality of life, compared with standard therapeutic education.

This prospective randomised controlled trial (1:1) occurred from 24 May 2022 to 27 October 2023. Patients in the Chatbot group had access to a Chatbot-based, educational smartphone application incorporating Global Initiative for Asthma (GINA) recommendations, and an algorithm validated by experts, including a member of the GINA scientific committee. By interacting with the Chatbot, patients could trigger a mechanism that directly alerted the pulmonology team when patient follow-up was required. The controls (Standard group) partook in standard therapeutic asthma education training. The primary outcome was change in Asthma Quality of Life Questionnaire (AQLQ) scores from baseline to 6 months.

48 of 69 (69.57%) of patients (mean±sd age, 48.43±16.38 years) were female. 29 of 34 (85.3%) in the Chatbot and 29 of 35 (82.9%) in the Standard group had severe asthma (GINA 4–5). Baseline AQLQ, asthma control (ACQ5) and spirometry metrics did not differ between groups. After adjustment, multiple regression analysis indicated that improvements in AQLQ scores were greater in the Chatbot group than in the Standard group (standardised β=0.279, 95% CI 0.004–0.555; p=0.047). Changes in ACQ5 and spirometry metrics did not differ between groups.

Use of the Chatbot-guided application for asthma education and support was associated with greater improvements in quality of life than standard therapeutic education.

A Chatbot-guided application provided educational content incorporating GINA guidelines and direct contact with pulmonology specialists. Compared with standard therapeutic education, its use was associated with improvements in QoL.
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