Project: A4A Connected+
App for Asthma Connected Plus (A4A+): implementing Internet-of-Things (IoT) solutions to support asthma self-management

Self-management is more than self-monitoring
Asthma self-management is far more than logging peak flow and medication use.
Asthma attacks can be triggered by allergies (such as pollen) or viral infections and it is important that everyone with asthma knows what to do if their symptoms or peak flows show that their asthma is getting worse. An action plan, agreed with their GP or asthma nurse, is therefore a particularly important component of self-management for people with asthma.
Other self-management support includes asthma education, communication with healthcare professions, lifestyle advice, help with medication adherence and (for some people) psychological treatments, and social support.
Connected asthma technology
New technologies such as smart inhalers, smart peak flow meters, pollen or pollution sensors and other smart gadgets connect to the internet to collect and transfer data. When these emerging technologies work together to help people to manage their asthma, we called them ‘connected asthma’ technology or an internet-of-things (IoT) system’. Increasingly, artificial intelligence can use all this data and provide feedback and advice to help people and their healthcare advisors to take the right decisions.
What we know
We know that supported self-management for asthma leads to better day to day control of asthma symptoms, less time off work or school and reduces the risk of an asthma attack.
We have identified a number of technological features that could support asthma self-management in a future connected asthma system. Many people want technology to watch over them ‘silently’ (for example, using a smart inhaler which can watch how often they need rescue medication) so they don’t have to enter symptoms scores or readings every day.
Our programme of work
We aim to design and test the ‘App for Asthma plus’ (A4A+) connected asthma system. This will be an IoT system that allows people with asthma to choose which devices they connect, if/when they want to share their information (for example with their doctor or nurse), and which is flexible so that new technologies can be connected later.
We have developed a prototype ‘app’, and asked people with asthma, and clinicians for feedback on A4A+ and how they thought new connected technologies might help. We also looked at whether they trusted the ‘connected asthma’ technology to help them look after their asthma.
Want to find out more?
Access the dataset
The dataset for this project is available on the University of Edinburgh Research Explorer
A4A App for Asthma on the University of Edinburgh Research Explorer
Publications and research outputs
Journal articles
Hui CY, McKinstry B, Fulton O, Buchner M, Pinnock H
JMIR Mhealth Uhealth. 2021 Jul 16;9(7):e24127. doi: 10.2196/24127. PMID: 34269684.
Hui CY, McKinstry B, Fulton O, Buchner M, Pinnock H
J Med Internet Res 2021;23(4):e22432 doi: 10.2196/22432
Hui, C., Walton, R., McKinstry, B., Pinnock, H
Health Informatics Journal. doi.org/10.1177/1460458219853381
Hui CY, McKinstry B, Walton R, Pinnock, H
BMJ Health & Care Informatics 2018;25: doi: 10.14236/jhi.v25i4.1056
Chi Yan Hui, Robert Walton , Brian McKinstry, Hilary Pinnock
What features do patients ‘want’ in a mobile asthma app?: a qualitative study
European Respiratory Journal Sep 2017, 50 (suppl 61) PA3874; DOI: 10.1183/1393003.congress-2017.PA3874
Chi Yan Hui, Robert Walton, Brian McKinstry, Tracy Jackson, Richard Parker, Hilary Pinnock
Journal of the American Medical Informatics Association, Volume 24, Issue 3, May 2017, Pages 619–632, DOI: 10.1093/jamia/ocw143
Recent conferences
Hui CY, McKinstry B, Buchner M, Fulton O, Pinnock for the A4A+ project team
Video presentation at The International Primary Care Respiratory Group (IPCRG) 10th World Conference 2021
Hui CY, McKinstry B, Buchner M, Fulton O, Pinnock for the A4A+ project team
ePoster at The Primary Care Respiratory Society (PCRS) Conference 2021
Hui CY, McKinstry B, Buchner M, Fulton O, Pinnock for the A4A+ project team
What features do patients and clinicians ‘want’ in the future Internet-Of-Things (IoT) systems for asthma: a mixed method study
ePoster at The European Respiratory Society (ERS) International Congress 2021
Key People
Professor Hilary Pinnock is the Principal Investigator and Dr Io Hui is the Co-Principal Investigator in this project. The team is supported by Professor Brian McKinstry, Mark Buchner (technology partner), Olivia Fulton (patient advisor), Susannah McLean (healthcare professional advisor) and Christopher Carlin (healthcare professional advisor), Simon Chapple (IoT advisor).
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Hilary Pinnock |
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Io Chi-Yan Hui |
Principal Investigator | Research Fellow | ||
Based at: University of Edinburgh | Based at: University of Edinburgh | ||
Hilary's Profile | Io's Profile | ||
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Brian McKinstry |
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Mark Buchner |
Professor of Primary Care E-Health | Managing Director, Tactuum | ||
Based at: University of Edinburgh | Tactuum Website | ||
Brian's Profile | |||
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Christopher Carlin |
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Consultant Physician and NHS Research Scotland Senior Investigator, Respiratory Medicine, NHS Greater Glasgow and Clyde |
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Christopher's Google Scholar Profile |
Device Collaborators
We thank Medical International Research and Smart Respiratory Products Ltd who provided devices for this research, and Findair and Polar Electro (UK) Ltd who provided API support.

Other collaborator:

We will use the Digital Health & Care Institute (DHI) simulation environment as part of the data interpretation workshop with stakeholders.
Funders for this programme of work
2019-current Medical Research Council Confidence in Concept
2018-2019 Asthma UK/CSO innovation grant
2014-2018 Chief Scientist Office (CSO) of the Scottish Government Chief Medical Officer (PhD Studentship)

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