Background Uncontrolled severe asthma often remains unidentified in clinical practice. There
is clearly an unmet need to identify patients with uncontrolled severe asthma and
design new strategies to improve and sustain asthma control.
Aim To identify patients with severe, uncontrolled asthma in routine practice and assess
changes in asthma control, treatment patterns, health outcomes, and environmental
influences over a 24-month follow-up through an innovative study design using 3 integrated
methods of data collection.
Methods The study population comprises severe (Global Initiative for Asthma [GINA] step 4/5),
uncontrolled asthma patients according to GINA guidelines. An enriched methodology
based on the combination of 3 integrated data sources is applied: an electronic medical
record (EMR) to collect relevant study information; an electronic case report form
(eCRF) to capture additional data; and the smartphone SaniQ App, to gather patients’
self-reported information and environmental factors. A software containing defined
trigger criteria based on WHO ICD-10 diagnosis codes and prescribed medication is
used in clinical practice to help physicians identify eligible participants from the
EMR. This software additionally captures patients baseline and follow-up information
directly from the EMR. Information that is not captured by the software is provided
by physicians via an eCRF. Lastly, a modified version of the SaniQ Lung App “AIRQ-Active”
— an easy-to-use patient smartphone app in special configuration for lung diseases
— collects patients’ information on asthma control, medication intake and physical
activity. The study outcome is the number of severe asthma patients at risk of exacerbation,
assessed by the Impairment and Risk Questionnaire (AIRQ). The AIRQ is a 10-item validated
asthma control tool that assesses both symptom impairment and exacerbation risk. Additional
outcomes are changes in medication use, physical activity, quality of life and environmental
factors. This innovative, patient-centered survey reduces the burden of data collection
in daily routine, increases data quality, improves efficiency in patient selection
and, for the first time, provides documentation of actual oral corticosteroids (OCS)
use through a simply implemented digital self-report.