Asthma UK Centre for Applied Research

Project: Connected for Asthma (C4A)

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

Presentation of work connected to the C4A study

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 Connect for Asthma (C4A) 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 C4A 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.


Publications and research outputs

Journal articles

Hui CY, McKinstry B, Mclean S, Buchner M, Pinnock H

Assessing the technical feasibility of a flexible, integrated Internet-of-things connected for asthma (C4A) system to support self-management: a mixed method study exploring patients and healthcare professionals perspectives

JAMIA Open, Volume 5, Issue 4, December 2022, ooac110. doi: 10.1093/jamiaopen/ooac10 


Hui CY, McKinstry B, Fulton O, Buchner M, Pinnock H

Patients' and Clinicians' Perceived Trust in Internet-of-Things Systems to Support Asthma Self-management: Qualitative Interview Study

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

Patients’ and Clinicians’ Visions of a Future Internet-of-Things System to Support Asthma Self-Management: Mixed Methods Study

J Med Internet Res 2021;23(4):e22432 doi: 10.2196/22432 


Hui, C., Walton, R., McKinstry, B., Pinnock, H

Time to change the paradigm? A mixed method study of the preferred and potential features of an asthma self-management app

Health Informatics Journal.


Hui CY, McKinstry B, Walton R, Pinnock, H

Strategies to promote adoption and usage of an application to support asthma self-management: a qualitative observational study

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 

The use of mobile applications to support self-management for people with asthma: a systematic review of controlled studies to identify features associated with clinical effectiveness and adherence 

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

What features do patients and clinicians ‘want’ in the future Internet Of Thing (IoT) systems for asthma: a mixed method study

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

Exploring how patients use a connected Internet-Of-Things system (A4A+) with off-the-shelf CE-marked devices to support asthma self-management? A mixed method study 

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).

headshot of Hilary Pinnock

Hilary Pinnock

headshot of Io Chi-Yan Hui 150x250

Io Chi-Yan Hui

Principal Investigator Research Fellow
Based at: University of Edinburgh Based at: University of Edinburgh
Hilary's Profile Io's Profile
Professor Brian McKinstry

Brian McKinstry

Headshot of Mark Buchner

Mark Buchner

Professor of Primary Care E-Health Managing Director, Tactuum
Based at: University of Edinburgh Tactuum Website
Brian's Profile  
Christopher Carlin

Christopher Carlin

Consultant Physician and NHS Research Scotland

Senior Investigator, Respiratory Medicine,

NHS Greater Glasgow and Clyde

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.

Logos for MIR Smartone, Smart Peakflow, Findair, and Polar

Other collaborator:

Digital Health & Care Institute Logo

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)

Logos of the MRC, Chief Scientist Office and Asthma UK

Contact us

Want to find out more?

Contact Dr Io Hui