IntroductionAsthmaTuner is a novel self-management system consisting of a patient app, a cloud-based storage solution and a healthcare interface. Patients use Bluetooth spirometers to measure lung function (forced expiratory volume in 1 s) and can register symptoms. They then receive immediate feedback on asthma control and an image of the correct inhaler(s) to use and the dose. The aim of this pilot study was to evaluate the effect of AsthmaTuner on symptom control and adherence compared with conventional treatment.Material and methodsThis multicentre physician-blinded crossover trial randomised patients in two groups that started with 8 weeks of AsthmaTuner or conventional treatment using a personalised printed treatment plan, with 2 weeks of washout between the crossover treatments. Participants in a primary or paediatric care setting in Sweden with asthma diagnosis, uncontrolled symptoms and Asthma Control Test (ACT) score <20 points were included. Symptom control was analysed using t-tests for the difference between the group means of the sums of ACT scores at each treatment end-visit, with 95% confidence intervals. Medical Adherence Report Scale (MARS) scores captured differences in adherence (remembering to take asthma medication) between treatment periods.ResultsThe study population consisted of 77 patients (60% females). The ACT score significantly improved with AsthmaTuner compared with conventional treatment (mean ACT difference 0.70, 95% CI 0.06–1.34; p=0.03). Adherence did not improve significantly in all participants, but did improve among those in primary care who used AsthmaTuner an average of once a week or more compared with conventional treatment (mean MARS difference 0.45, 95% CI 0.13–0.77; p=0.01).ConclusionsAsthmaTuner improved symptom control in patients with uncontrolled asthma compared with conventional treatment.

Occupational exposure accounts for a substantial proportion (16%) of adult asthma [1, 2] and asthma may also be aggravated by triggers at the workplace. Serial measurements of lung function with a peak expiratory flow (PEF) meter may confirm work-related asthma and is recommended in US, European and Swedish national guidelines [3-7]. PEF should ideally be measured at least six times a day at the workplace and at home over a period of several weeks [8], noted down and subsequently analysed. The time-consuming and cumbersome nature of serial PEF thus limits its clinical usefulness [9]. However, this could potentially be alleviated by digital health point-of-care tools [10]. AsthmaTuner (Medituner AB, Stockholm, Sweden) is a cloud-based system for collection and analysis of lung function and symptoms using a wireless spirometer and a smartphone application [11]. We conducted a prospective nonrandomised clinical trial comparing the standard method of serial PEF to AsthmaTuner in patients with suspected asthma referred to the occupational medicine clinics at Lund,

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