Health App Shown to Improve Asthma, Depression Outcomes

(Dariusz Sankowski, Pixabay. https://pixabay.com/photos/iphone-6s-plus-iwatch-apple-white-1032783/)

11 Aug. 2023. Findings from two clinical trials show a digital health mobile app helps improve outcomes and manage the conditions for people with depression and asthma. Results of the trials, conducted by Juli Health, developer of the juli app — the name is spelled in all lower-case — appear in separate postings on the pre-print server medRxiv and are not yet peer-reviewed.

The juli app, says Juli Health, provides users with a single platform for recording data and experiences related to chronic conditions including asthma, migraine, depression, bipolar disorder, hypertension, and chronic pain. The app combines health, activity, and wellness data gathered passively from Apple phones and watches, with data entered by users on their medications, mood, and related factors, and with third-party reports on weather, pollen, and air pollution. The app also engages users through Q&A chat and game features to gain more insights.

The juli app, available only for the iPhone, integrates with Apple Health to capture data from phones and watches. The collected data, says the company, are processed with artificial intelligence algorithms to provide feedback and guidance to encourage a series of micro-level behavioral changes among users related to their health conditions.

A team from Juli Health and University College London assessed the app in two separate clinical trials among users with depression and asthma. The first trial enrolled 908 adult participants who self-identified with depression and scored above a specified threshold on a standard patient health questionnaire. Participants were randomly assigned to use either the full juli app or a limited/placebo app that asked only about the user’s overall condition each day, for eight weeks.

Gains on primary measures in both trials

The researchers looked mainly for changes in depression scores on the standard health questionnaire, but also on other depression-state and quality of life indexes, with 456 participants completing the trial. Results show participants using the juli app record lower depression scores on the patient health questionnaire than limited-app users, with differences large enough for statistical reliability. The data show statistically reliable reductions in some, but not all, secondary depression health and quality-of-life scores.

The second trial recruited 411 adult participants self-reported with asthma, and scoring low on an index-test for controlling their asthma. As in the first trial, participants were randomly assigned to use either the juli app for eight weeks, or a limited/placebo app that asked only about daily general well-being. After two weeks, 262 participants were still in the trial, enabling some partial analyzes, with 152 participants completing the trial.

The study team looked primarily for changes in participants’ scores on the asthma control test, but also for scores on related asthma condition measures and quality of life. The findings show after eight weeks, juli app users score higher on the asthma control test than limited-app users, with statistically reliable differences. Differences in other measures of asthma control and quality of life, however, are not large enough for statistical reliability.

“Our studies not only demonstrate the effectiveness of the platform,” says Joseph Hayes, professor of psychiatry at University College London, Juli Health co-founder, and senior author of both studies in a company statement released through Cision, “they also show that juli works across the very different conditions of asthma and depression, validating our approach to cover multiple chronic conditions, including their comorbidities.”

Juli Health is a three year-old enterprise based in Boston. In Mar. 2022, Science & Enterprise reported on the company raising $3.8 million in seed funds.

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