While the app technology is developing at a fast pace, it seems the evidence is not keeping up to say how asthma patients might use these devices. 

Annette Pluddemann

334 million people globally have asthma with 1 in 7 of the world’s children experiencing asthma symptoms that require lifelong management. Pulse oximeters are marketed to help with asthma self-management, and a visit to your App store shows there are several available. But are these helpful in self-managing asthma?

Pulse oximeters are simple, non-invasive devices that measure blood oxygen levels and are used by doctors to assess asthma severity and make treatment decisions.   You can buy them from some pharmacies and online, (e.g. see here and here).

Some patients might, therefore, think this device could be useful to help monitor their asthma and some patients use them during an acute attack to monitor their blood oxygen levels. A 2015 Cochrane systematic review found no trials assessing self-monitoring of asthma using pulse oximeters to help inform whether or not it is helpful for asthma patients to use pulse oximeters.  The review did, however, highlight that people should not use a pulse oximeter without advice from a healthcare professional.

A 2013 Cochrane systematic review of smartphone and tablet self-management apps for asthma found two randomised controlled trials assessing the effect of a mobile phone-based asthma self-management intervention on asthma control. One study showed that using the app did not affect asthma symptom scores, while the other found the app resulted in higher asthma-related quality of life and fewer visits to the emergency department. But there were no differences in either study for other asthma complications between those using the app and those using traditional paper-based self-management.

A 2017 review found 38 different apps (13 available for both iOS and Android), and while some had the potential to improve asthma self-management, many apps were of low quality: ‘no study was identified that evaluated the efficacy of any of the included asthma apps.’

So should patients be using pulse oximeters and apps to help self-manage their asthma? For researchers, the answer is “more research needed”. Unfortunately for patients, the answer at the moment is “we just don’t know”.

Annette Pluddemann is Director of the MSC in EBHC and Research Fellow at the Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford.

Competing interests: None declared

Acknowledgements: Carl Heneghan for useful suggestions.