Davos@home: eHealth support of patients with severe asthma during and after AACT (Alpine Altitude Climate Therapy)

In uncontrolled or severe asthma, alpine altitude climate treatment (AACT) may be used as add-on therapy, according to the Dutch severe asthma guidelines. AACT at the Davos Asthma Centre Davos combines a clinical multidisciplinary treatment programme with environmental trigger avoidance in the alpine climate. The treatment includes optimisation of asthma control, interactive patient self- management education, a personalised exercise program and sessions addressing behavioural aspects of living with a chronic disease and problems such as anxiety, stress and depression. Once the patient returns to his/her home environment, there is a risk of relapse. In a previous project we showed that such a relapse in patients with severe asthma after discharge from AACT can be partially attenuated by eHealth support of self-management with a web-based application called PatientCoach. We improved PatientCoach based on feedback of patients and professionals and made it available as an application for a smartphone.
Recent advances in the use of bio-wearables and home-monitoring systems might also improve asthma outcomes and could be integrated into PatientCoach. These potential improvements must be weighed against feasibility of use, since more devices and measurements also require more time.

We plan to perform a pragmatic randomized controlled trial in which we will evaluate the clinical effectiveness of the PatientCoach app with home-monitoring devices (intervention) as compared to the PatientCoach app without home-monitoring devices (control) in patients with severe asthma after AACT with a follow-up period of 12 months.

The use of the ehealth application PatientCoach combined with home monitoring devices supports sustained long term asthma control after AACT

Baseline, 3 months, 6 months, 9 months, 12 months.

PatientCoach app with home monitoring devices (spirometer, activity meter, FeNO measurement device)