The impending arrival of the smart inhaler might herald the beginning of the smart healthcare age.
It is important, however, that proper planning and rigorous testing is carried out to ensure smart-enabled care pathways deliver the best outcomes for people with asthma and the NHS, says a new report published by Asthma UK.
The report outlines both the opportunities and possible pitfalls for the UK at the start of a potential revolution in asthma management.
Globally, over 300 million people have asthma, and this number is expected to rise by 100 million by 2025.
In the UK, 5.4 million people are currently receiving treatment for asthma and there are over 6 million primary care appointments for asthma each year.
A recent survey of people with asthma as part of the EU-funded myAirCoach study suggests that three-quarters would already be willing to carry a connected device that could help them better manage the condition through monitoring their inhaler usage.
Smart inhalers are designed to help people with asthma ensure they are taking their medication as prescribed, by recording the timing and dosage taken on their smartphone.
The data collected can be used by a clinician to check that prescribed treatment is working and to personalise asthma reviews to focus on root causes of worsening symptoms, as well as to inform early warning systems for when to seek medical attention.
This technology could enable a move away from one-size-fits-all asthma reviews, and lead to fewer routine appointments which could help relieve pressure on the NHS.
The market for smart inhalers is poised to expand, says the report, and asthma could provide a template for the use of connected technologies at scale.
However, the report identifies the need for investment in a significant programme of research and testing to assess the accuracy, cost effectiveness and user experiences of these new technologies, as well as the right implementation models to deliver the best care and clinical outcomes.
Whilst smart inhalers have been shown to be effective in previous studies, there are practical considerations for real-world implementation in the NHS.
With over 90 (non-smart) inhalers currently on the UK market and many people with asthma prescribed at least two, people with asthma will need be able to switch between their treatments and prescriptions seamlessly, without being tied to a particular device or app, or be expected to manage two different systems.
NHS commissioners will no longer be purchasing just medication in the form of inhalers, says the report, but also other components to make the whole system work – such as the sensors, cloud services, user mobile apps and clinical support systems.
How these are designed and priced from the start could have far-reaching impacts on how smart inhaler technology is adopted across the NHS, and whether the maximum number of people could potentially benefit.
Kay Boycott, chief executive of Asthma UK, said: “The UK is a global leader in academic and commercial research, and the NHS provides the perfect platform to develop, test and commercialise innovation at scale. The UK has much to gain from radically redesigning asthma care with new technologies, but much to lose if this is done badly.”
“This report demonstrates the need for a considered approach that builds the evidence base and sets the stage for successful widespread adoption. We will need sufficient time for testing before we are locked into one system as the default pathway or commissioning option.”
“People with asthma will not want to use devices designed around the needs of clinicians rather than their own lives and are likely to want options on how connected devices are used in their care. It is also important to have transparency in how data is being collected and used, and who is in control of the data being produced.”
“How we choose to implement asthma digital health in the NHS in the next five years is likely to set the direction for the next 20 to 30 years. We need to understand both the opportunities and the pitfalls, ensuring the needs and preferences of people with asthma are at the very heart of these important decisions.”
Another Asthma UK report, also outlines how technologies already in existence, including smart inhalers, electronic alerts and digital action plans could be used to completely transform the NHS asthma care pathway by reducing routine GP appointments and enabling people to manage their own condition.