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 Abdullah 1, Wei Leik Ng 1, Norita Hussein 1, Chee Sun Liew 2, Wee Cheah 3, Chun Lin 4, Chng Saun Fong 5, Ping Yein Lee 6, Darwish Mohd Isa 7, Afifah Tahar 3, Chin Hai Teo 1, Norimichi Hirahara 6, Chee Kuan Wong 8, Nasrin Aghamohammadi 7, Mohd Talib Latif 9, Maggie Chel Gee Ooi 10, Amy Stidworthy 11, Daniel Conolly 11, Nik Sherina Hanafi 1, Siti Nurkamilla Ramdzan 1, Rizawati Ramli 1, Ai Theng Cheong 12, Sazlina Shariff Ghazali 12, Poh Ying Lim 13, Hani Syahida Salim 12, Jay Evans 4, Bee Kiau Hoo 14, Hillary Pinnock 4, Ee Ming Khoo 1 1 Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 2 Department of Computer System & Technology, Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia 3 Institute of Ocean and Earth Sciences, Universiti Malaya, Kuala Lumpur, Malaysia 4 NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom 5 Institute for Advanced Studies, Universiti Malaya, Kuala Lumpur, Malaysia 6 UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 7 Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 8 Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 9 Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia 10 Center for Tropical Climate Change System, Institute of Climate Change, Universiti Kebangsaan Malaysia, Bangi, Malaysia 11 Cambridge Environmental Research Consultants, Cambridge, United Kingdom 12 Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia 13 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia 14 Botanik Health Clinic, Klang District, Ministry of Health, Klang, Malaysia