Development and Usability Validation of e-ASMA: A Tool for Asthma
Assessment, Support, and Monitoring
Asthma; Mobile Health; Self-Management; Development; Disease Management; Telemedicine
Introduction: Asthma is a chronic respiratory disease
characterized by airway inflammation, variable respiratory
symptoms and airflow limitation. Mobile health strategies have
demonstrated potential to optimize treatment, enhance self-care,
and reduce adverse events. However, there is limited availability
of tools, particularly national ones, thereby justifying the
development of e-ASMA. Objectives: To develop, structure, and
validate the usability of e-ASMA as a digital health tool for the
assessment, monitoring, and support of asthma self-
management in the Brazilian population. Methods: This is a
software development study based on the Double Diamond
model and the Software Development Life Cycle (SDLC). The
project received ethical approval from the Research Ethics
Committee of the Federal University of Rio Grande do Norte.
The development of e-ASMA involved medical specialists,
information technology professionals, and patients with asthma
across different age groups, from conception to usability
validation. The process was conducted in five stages: (1)
requirements analysis, (2) definition of functionalities, (3) design
definition, (4) prototyping, and (5) usability validation. Throughout
these stages, existing asthma management applications were
analyzed, expert interviews were conducted, and standardized
usability tests were applied, ensuring a user-centered approach.
Results: During the requirements analysis phase, 11
applications were evaluated, of which only one was developed in Portuguese. None of the analyzed applications included
questionnaires validated for the Brazilian population. Two
applications incorporated integrated educational materials. Key
functionalities conceptualized for e-ASMA include the generation
of clinical reports, a customizable asthma action plan, tailored
asthma education, and assessment of asthma control using a
nationally developed instrument. In total, e-ASMA comprises 12
functionalities and 255 interface screens. Prototyping was
performed using the Swift programming language (iOS platform).
Usability validation involved adults with asthma (n = 14),
parents/caregivers (n = 8), and children/adolescents (n = 8). The
application achieved a mean score of 4.31 on the uMARS (adults
and parents/guardians) and 69.06 on the System Usability Scale
(pediatric population). Conclusion: e-ASMA is an evidence-
based, user-centered digital health tool developed to support
asthma management. By integrating clinical, educational, and
continuous monitoring features, it promotes self-care, therapeutic
adherence, and optimization of communication between patients
and healthcare professionals.