A Pilot Randomized Controlled Trial of an Air Quality Mobile Application Alert System to Improve Asthma Control in Malaysia

27 Mar 2025
Introduction: Poor air quality exacerbates asthma symptoms, making effective interventions crucial. Early warnings of poor air quality can help patients with asthma take necessary precautions. This study aimed to assess the feasibility of a randomized controlled trial evaluating a mobile health app providing high-resolution air quality forecasts to support asthma self-management. Methods: Adult patients with asthma were recruited from a public health clinic in Klang, Malaysia, and randomised into either the intervention group (using the Air Quality app) or the control group (usual care), with 30 patients in each group. The primary endpoint is asthma control, measured using the GINA Asthma Symptoms Control tool at baseline, 1, 3, 6, and 12 months. Secondary endpoints include clinical outcomes (exacerbations, emergency visits, asthma action plan usage, medication usage, peak flow rate) and system-related outcomes (utility, usability, drop-out rate). Results: Recruitment and baseline data collection are ongoing, with 38 patients recruited so far (19 in each group). 10 recruitment failures occurred due to various issues (busy schedule, change of residence, health and transport problems). Challenges include app incompatibility (only for Android phones) and patient availability for follow-up. 10 patients completed the 1-month follow-up (intervention: 6, control: 4). No drop-outs or significant differences in asthma control between groups have been observed (X2 = 3.75; p = 0.15). The app's utility is limited. Discussion: This pilot study will provide insights into the feasibility and implementation of a mobile-based air quality alert system to enhance asthma management in Malaysia. Lessons learned from this pilot will guide the refinement and scaling of the intervention to a full-scale RCT.

Resource information

Respiratory conditions
  • Asthma
Type of resource
Abstract
Conference
Brasov 2025
Author(s)
Adina Abdullah1, Wei Leik Ng1, Norita Hussein1, Chee Sun Liew2, Wee Cheah3, Chun Lin4, Chng Saun Fong5, Ping Yein Lee6, Darwish Mohd Isa7, Afifah Tahar3, Chin Hai Teo1, Norimichi Hirahara6, Chee Kuan Wong8, Nasrin Aghamohammadi7, Mohd Talib Latif9, Maggie Chel Gee Ooi10, Amy Stidworthy11, Daniel Conolly11, Nik Sherina Hanafi1, Siti Nurkamilla Ramdzan1, Rizawati Ramli1, Ai Theng Cheong12, Sazlina Shariff Ghazali12, Poh Ying Lim13, Hani Syahida Salim12, Jay Evans4, Bee Kiau Hoo14, Hillary Pinnock4, Ee Ming Khoo1 1Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 2Department of Computer System & Technology, Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia 3Institute of Ocean and Earth Sciences, Universiti Malaya, Kuala Lumpur, Malaysia 4NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom 5Institute for Advanced Studies, Universiti Malaya, Kuala Lumpur, Malaysia 6UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 7Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 8Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 9Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia 10Center for Tropical Climate Change System, Institute of Climate Change, Universiti Kebangsaan Malaysia, Bangi, Malaysia 11Cambridge Environmental Research Consultants, Cambridge, United Kingdom 12Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia 13Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia 14Botanik Health Clinic, Klang District, Ministry of Health, Klang, Malaysia