Smart technology is playing an increasingly prominent role in how we look after our health, and manage long-term medical conditions. Asthma is a notable example; for the 5.4 million people in the UK living with asthma, new tech is being developed to help people stay well, and prevent asthma attacks.
To get an insight into this new technology, we got in touch with Dr Samantha Walker, Director of Research and Policy at Asthma UK, to discuss:
- asthma care as it is today
- what new tech is on the horizon
- when and how this might be integrated into everyday care
- the challenges new asthma tech brings
- how healthcare professionals will benefit
- and what other innovations we may see in the future.
Because asthma is a very individual condition, effective management can present various challenges for both patients and healthcare professionals; current treatment frameworks are not always optimised to deliver bespoke patient care.
‘Asthma is a condition with multiple triggers and can vary in severity across a person’s lifetime,’ Dr Walker tells us, ‘and attacks can be sudden and unpredictable.’
‘Currently, medical guidelines take a ‘one size fits all’ approach to asthma management which doesn’t work effectively for many people. Asthma UK’s latest annual asthma survey found two thirds of people are still not even receiving basic care for their asthma. We recommend personalised support for people with asthma and new technologies provide an exciting opportunity for this.’
The ever growing demands being placed on the NHS mean that a push to improve the self management of asthma would likely benefit both patients and the health service as a whole.
‘There is overwhelming evidence that supporting self-management of asthma can improve quality of life for people with asthma and save lives.’ Dr Walker explains. ‘If we can provide personalised action plans for people with asthma it can empower them to self-manage their condition, which could in turn be life changing.’
So, what would the specific aims be of new technology in improving asthma patient care?
‘Patients could be better equipped to recognise when their symptoms worsen and what to do in an emergency.’ Dr Walker says. ‘Asthma UK’s recent research, however, found that only 43% of people with asthma received a personalised plan and they are paper-based rather than digital, which isn’t convenient for many patients.’
A number of different technological approaches to improving asthma management are being explored.
One promising area of development is smart inhalers.
‘Smart inhalers are devices that are designed to link to a smartphone and detect when someone is using their inhaler.’ Dr Walker tells us.
‘By using Bluetooth technology, smart inhalers can track how people use them in real-time. These are an exciting new innovation which could help people with asthma take their medications properly by building a picture of their overall medication use.’
Adhering to an asthma treatment plan can be difficult for some patients. This means that their asthma may not be as well managed as it could be, leaving them at risk of an asthma attack.
The introduction of smart inhalers could significantly change this, Dr Walker thinks:
‘Smart inhalers could potentially encourage people to use their inhalers more regularly, better manage their condition, and in the future, data could be shared with a health professional to help them work together to manage their symptoms.’
‘However, there is a need for further testing of smart inhalers in real world settings in the NHS to improve effectiveness. There is more information about this in Asthma UK’s Connected Asthma report, which can be found here.’
One of the aims of new technology is to provide patients with a more convenient way of staying on top of their condition. Smartphone apps, being accessible to most people most of the time, are an obvious choice to help monitor symptoms, provide useful bespoke info, as well as aid in the delivery of a tailored treatment plan.
‘They have the potential to help people with asthma receive personalised information to self-manage their condition.’ Dr Walker says.
‘These need to be better developed to suit user needs, but could give people information on avoiding triggers such as air pollution or pollen, in addition to storing a person’s asthma action plan which can help prevent asthma attacks.’
Health apps could encourage patients to take a more active role in their own care. Patients who feel empowered may be more likely to adhere to their treatment plan, and even advocate for their condition.
While the primary aim of smart inhalers and smartphone apps is to encourage patients to take better control of their asthma outside of clinic, the information being gathered can also be put to good use by healthcare professionals, and possibly even enable them to intervene where required.
As Dr Walker elaborates:
‘Remote monitoring could be pivotal in helping healthcare professionals better support people with asthma, with future technology potentially being able to detect when a person’s asthma is getting worse, so they can respond promptly to prevent an asthma attack. We are supporting research into creating a personalised asthma monitoring system.’
While it’s encouraging to read about the innovations being made in asthma management, patients who are currently living with the condition will be keen to know when the new technology will be available to them.
As is often the case though, integrating new health technology into everyday use does inevitably come with its own set of challenges.
‘Existing technology with a proven track record of effectively helping people with asthma needs to be introduced into the NHS to improve asthma care.’ Dr Walker tells us.
‘Currently only one GP software provider offers a digital personal asthma action plan – we encourage all providers to make this available to people with asthma. Improved systems also need to be introduced to help improve quality asthma care.’
Dr Walker goes on to say that: ‘New technologies need to be carefully designed with the asthma user in mind. Asthma UK want to see greater investment to develop innovative technology aimed at helping people self-manage their asthma.’
The NHS is said to be pushing for a set of agreed digital standards.
As Dr Walker explains: ‘within the NHS, there needs to be a suitable process to help ensure that innovations are rapidly introduced in a safe way. As an initial step, we want to see the NHS introduce a programme of testing for smart inhalers in the UK, so that people with asthma can soon begin to benefit from the exciting innovations being developed.’
The health and safety of patients should always be of the utmost importance when developing new technologies. Patient needs have to be taken into consideration in order for new technology to be effective and beneficial.
Dr Walker thinks that involving asthma patients in this development is crucial.
‘Any successful app needs to be user friendly, but so far the development of most asthma apps haven’t involved people with asthma sufficiently. The key to making an app patient friendly is to enable it to collect data passively (this means when it’s collected by a smart inhaler or wearables, rather than a person having to enter data manually.).’
The research and development into new digital health products is both time-consuming and costly. Each potential new idea is likely to come up against several hurdles before the product can be safely distributed amongst patients.
‘Asthma research remains chronically underfunded and consequently asthma is poorly understood and treated,’ says Dr Walker. ‘Asthma has always been assumed to be one condition, but we now know there are different subtypes which change over time and respond to different treatments. However, due to lack of funding we’ve made very little progress in identifying what they are.’
This lack of understanding has led to something of a reliance on a narrow pool of treatments, as Dr Walker goes on to explain: ‘For decades, inhaled steroids have been prescribed as the one size fits all treatment to control symptoms, yet we now know as many as half of people with asthma respond poorly to steroids.’
Whilst the potential benefits for patients could be seen as the driving force behind the push for new technology; the improvements new tech will bring to processes and practices for healthcare professionals is also vital.
As Dr Walker tells us: ‘There are interesting new clinical decision algorithms being developed which could assist health professionals to give the right treatments to the right people at the right time. Again, if a person with asthma uses technology which gathers real time information that can be shared with their GP or practice nurse, their treatment could be tailored to meet individual needs.’
Doctors working in general practice and other primary care settings, who have regular insight into the lives of their asthma patients, are in a good position to influence the areas being focused on by digital health companies.
The research and development of new technology to improve asthma care is ongoing.
Dr Samantha Walker says that ‘while things like risk algorithms, telehealth and mobile apps could transform asthma care, the quality of current asthma apps is very variable.’
‘However, Asthma UK believes it’s an incredibly exciting area of development and is helping drive ideas forward. We hope in the future data innovations and artificial intelligence could help those most at risk from life-threatening asthma attacks because guidance will be personalised to an individual, and the best treatment could be sought as fast as possible.’
In order for the new technology to be successfully integrated into the daily lives of asthma patients, several areas of the healthcare industry need to work in harmony. The introduction of health tech into asthma care has the potential to be life changing for many patients, so Dr Walker thinks the push for integration can’t come soon enough.
‘As Asthma UK’s recent report - Diagnosing asthma: A 21st Century Challenge - outlines, there is an urgent need to develop better diagnostic tools to identify the type of asthma someone has and to make sure people are getting the correct treatment. Asthma researchers and people with asthma across Europe, through the European Asthma Research & Innovation Partnership, have highlighted technology-enabled asthma management tools as one of the highest priorities for asthma research but much more investment is needed to realise the potential benefits.’
Asthma UK funds cutting-edge research into better asthma treatments and a cure, provides online health advice and works with digital health innovators developing digital products for people with asthma. For advice on how to manage your asthma visit asthma.org.uk