05:30am Wednesday 01 April 2020

Smart device delivers results for kids with asthma

The users also experienced significant improvements to their symptoms, well-being and quality of life and needed their reliever medication less frequently.

The University of Auckland study, funded by Cure Kids and the Health Research Council, showed a significant improvement in night time awakening, coughing and wheezing.

Clinical pharmacist, Amy Chan, a doctoral student with the University of Auckland, is the lead author on the paper.  

“We know one of the key reasons for children not taking their medication is parent and patient forgetfulness.  The Smartinhaler reminder system is now clinically proven to be a real solution to the problem,” she says.

“What we’ve been able to establish for the first time with this study is that the ringtone Smartinhaler significantly improves adherence to preventative medication, which results in improved quality of life for children with asthma. It’s hugely exciting,” says Ms Chan.

Children in the study were also given a Smartinhaler tracker for their rescue or ‘blue’ inhaler to measure the amount of rescue medication they used. The device was able to objectively count date and time of rescue medication use. This provided a good indication of asthma being out of control.

When symptoms worsened participants used their rescue reliever inhaler (blue inhaler), which is also known as a rescue medication because it provides immediate relief.  Recent studies have shown that overuse of the blue inhaler is a predictor of worsening asthma and general morbidity.

The study found that use of the rescue medication was significantly reduced in the group using the Nexus6 Smartinhaler reminder device.

Cure Kids Chair of Child Health Research and Ms Chan’s supervisor on the study, Professor Ed Mitchell, says he is “absolutely staggered by the size of the effect. To see the improvement in the lives of these children is astounding.”

The participants also reported taking part in more sports and family activities. Parents reported feeling less frightened by their child’s asthma.

New Zealand has the second highest rates of asthma in the world and one in four Kiwi children experiences asthma symptoms. Despite this, regular adherence to asthma medication is poor.

New Zealand digital health company Nexus6 Ltd created the new Smartinhaler device called the SmartTrack, which was used in the study. The device has 14 different ringtones, which are cycled so users don’t get reminder fatigue. The SmartTrack reminder is only triggered when a dose is missed.

The results were published this month in The Lancet Respiratory Medical Journal.  To the researchers’ knowledge, this is the largest study in the world to investigate the effects of an inhaler device with audio-visual reminder function on asthma adherence and outcomes in children and adolescents.

It is also the first to show significant benefits in asthma outcomes and quality of life. The results are expected to gain international interest.

The controlled trial recruited 220 children between the ages of six and 15 who presented to emergency departments with asthma symptoms.

The study was randomised with half of the participants receiving a SmartTrack device for use with their preventative or ‘orange’ inhaler that had the audiovisual elements turned on, and the other half receiving the same device with the audiovisual elements turned off.

Participants were followed up every two months for six months and general asthma control was checked.

Key findings from the study were:

  • Medication adherence rate for the patient group given the audiovisual enabled SmartTrack inhaler were 84 percent compared to 30 percent for the control group. This equals a 180% increase in medication adherence.
  • The use of emergency medication or the ‘blue’ inhaler was significantly reduced. The median percentage days on which a reliever was used in the intervention group was 9.5 percent compared to 17.4 percent in the control group. This equals a 45percentreduction in rescue medication use.
  • Symptoms, well-being and quality of life for the children was significantly improved.

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