Background Digital platforms for asthma support improved symptom control and adherence, but few studies have explored its impact on outcomes and retention, when combined with virtual care.

Methods We compared outcomes for patients enrolled in a digital self-management platform (DP) vs. DP + therapeutic resource center (DP+TRC). DP included medication sensors capturing inhaler usage, and a patient app providing medication reminders, education and feedback (Propeller Health). TRC (Evernorth) was staffed by virtual clinical pharmacists who accessed patient DP data via a web dashboard. Clinical pharmacists reached out to patients with worsening asthma symptoms and poor controller adherence. Controlling for age, medication use and first sync year, controller adherence, short-acting beta-agonist (SABA) use, and program retention were assessed over 6 months, and between baseline and follow-up.

Results We assessed 21,936 DP patients (mean age (SD): 33(15) yrs, 89.9% uncontrolled asthma (ACT<19)), and 4,224 DP+TRC patients (mean age (SD): 44(16) yrs, 49.4% uncontrolled). Among initially uncontrolled patients at 6 mo, DP+TRC vs. DP had significantly better retention (57% vs. 41%), adherence (56% vs. 45%), and mean daily SABA use (0.6 vs 0.9 puffs/day), respectively (all p<0.02). The odds of achieving >80% adherence was 1.12 (95% CI: 1.06, 1.19) in DP+TRC vs. DP (p<0.0001). From baseline to 6 mo, both programs had improvements in mean daily SABA use (both p<0.001) and the % of SABA-free days (both p<0.001).

Conclusions A digital-only platform was associated with improved asthma outcomes, but when it was paired with a virtual clinical pharmacist, both clinical outcomes and program retention were further enhanced.