Asthma UK Centre for Applied Research

Discussing smart technology for asthma self-management at the Lung Health Cross Party Group at the Scottish Parliament

Following her presentation to the Scottish Parliament Cross Party Group on Lung Health, our volunteer Patient Lead, Olivia Fulton, considers the use and the future of smart technology for self-management of asthma

Olivia Fulton
Volunteer Patient and Public Involvement Lead, Olivia Fulton

I was recently asked to speak at the Cross Party Group (CPG) Meeting for Lung Health at the Scottish Parliament. I am a member of the Scottish Patient Advisory Group and one of 5 members who represent people with asthma in Scotland.

The topic I was asked to speak on is an area close to my heart. It is also very relevant just now, as we are in the middle of the COVID-19 pandemic: “The benefits of using smart technology for asthma self-management”. Although the focus was asthma for the CPG meeting, I wanted to make sure that people are aware of the benefits of smart devices across all lung health conditions.

It is so important that patients are given the opportunity to speak at events such as this as it is one of the main ways we can influence policy and change. Speaking at meetings where policy makers are present is one of the most powerful things a patient advocate can do. After all, we live with the condition. We know exactly how it affects us and impacts not only our lives, but that of our friends and families as well.

My perspective as a person with asthma and a user of smart technology

I was first intrigued by smart technology for managing my asthma over 15 years ago. I have severe asthma which is very tricky to control. I was fed up of being questioned about my adherence to medication and the way I managed my asthma. The team I was under didn’t seem to believe that my asthma was still so severe despite me taking my medication. I was looking for a way to prove to them that I was doing what I could to manage my health and act on symptoms and reduction in peak flow.

The first hurdle I encountered was getting my hands on smart technology. Smart phones were still in their infancy so there were no apps or anything like that available. You did have a digital peak flow meter that could be plugged into a computer and the results uploaded but this was very expensive and not available on the NHS: issues that are still a factor today. Due to the amount of severe asthma patient advocacy work I do, I have been very fortunate to receive various devices from companies. I have had the opportunity to test them out and see how they fit in my every day asthma management.

Smart technology in asthma management and lung health can be divided into 3 main categories: smart inhalers, smart peak flow and spirometry meters, and mobile applications on your phone/ tablet.

Smart Inhalers:

I found these quite helpful particularly when used on my reliver inhaler as it helped identify trends in use. I was able to see my asthma was not quite right when I looked at my usage and saw an increased in use particularly in the evening and night. I can see the real benefits to people who are new to asthma or are maybe not good at taking their medication: you can set yourself reminders. The price of these devices is a real drawback just now which means they are not readily available for people to use. I have had the chance to try a few different devices, some of which have had fundamental flaws particularly with design. Working with patients when designing such devices is key for their future success.

Smart spirometers:

This is a nice tool to have. However, I found that the results you get are quite complex and I did not feel confident interpreting the results and acting on any change I saw. During the pandemic, it has been very useful as it has allowed me to give my consultant my spirometry results when having my telephone consultations. I would always do spirometry when attending clinic so this was helpful and helped inform him how my lungs are.

Smart peak flow meter:

This is probably my favourite smart tool when it comes to every day asthma management. I have tried several different devices. All have pros and cons, but there is one I have settled on due to its ease of use, simplicity of the results and the app that comes with it.

Mobile Apps:

Apart from the app that comes with one of the smart peak flow devices I have not found an app that does everything I want it to do. As a result, I need to use several different apps and even then I don’t have everything I really want. The fundamental thing that is lacking is action. I input my data into the apps but it does not work like a personal asthma action plan. I and many others I know want to people able to input data and based on this it will say if you need to increase your medication or give other care advice.

Using smart technology in everyday life with asthma

I have been able to integrate the use of smart technology into my asthma management. However, the first main issue I found when using smart tech in everyday life is they are all used independently of each other and there is no way to sync all your data to hold it in one place. You need to use different programmes for different management techniques.

It is very labour intensive due to the number of different apps you require for different aspects of management. Because I am invested in my asthma management and want to learn as much as possible about my asthma, I am prepared to put the time in. But some people will not have the time and won’t want to use different apps. In the long term, there are certain devices I will continue to use: particularly a smart peak flow meter. I am not sure how useful the other devices are to my day to day management.

The future of smart technology to aid asthma self-management

Smart technology no doubt has an important role to play in asthma self-management, but there is a lot of work that needs to be done before it will become mainstream. The biggest development that needs to be made is being able to have all your data from these devices stored in one place. This way, you can compare your results against each other.

Not only is smart technology helpful for people with asthma, but also for the NHS. It means that teams can monitor their patients and how their asthma or lung condition is. Rather than needing to call the patient in to the clinical setting, to be reviewed and actions taken, clinicians can give care advice directly to people with asthma based on the data available from these devices. Removing this step could improve the level of care people with asthma receive and reduce the workload for clinicians. When working as a home dialysis nurse I was able to benefit from smart technology by using a smart dialysis machine that could be accessed and programmed remotely.

I’m looking forward to seeing the changes in the smart technology available for asthma management. It would be fantastic to see patients and industry working together to produce smart technology that is really usable for people with asthma and other lung conditions.

Public Involvement at the Centre