The Asthma and me study
Research type
Research Study
Full title
Self-care, remote monitoring and elearning for children and young people with asthma (The "Asthma and me study")
IRAS ID
240906
Contact name
Heather Elphick
Contact email
Sponsor organisation
Sheffield Children's Hospital NHS Trust
Duration of Study in the UK
0 years, 5 months, 0 days
Research summary
Research Summary:
Asthma is a long-term condition in children, often managed by general practitioners (GPs) in primary care but some children with asthma need hospital treatment and care by experienced paediatricians and nurses. The positive effects of treatment for childhood asthma are well-documented however, less than 50% children take their medications regularly as prescribed. As well as causing poor control of asthma symptoms, failing to take medication as prescribed is a problem that is causing huge cost and wastage to the NHS.
Some of the barriers to taking medications as prescribed include people’s beliefs about their illness or medications and forgetting or being too busy. These barriers can be addressed by providing education, reminders and incentives.
Monitoring medication usage is complex but studies have shown that use of electronic monitoring devices with education does improve the number of asthma attacks. Digital solutions for asthma self-care, including “smart-inhalers” that monitor medication usage and Apps for remote monitoring and self-management are likely to transform health services by providing supported self-management, prioritisation of the more unwell patients and reductions in hospital visits.
Asthma + me, a digital self-care solution has been developed by Aseptika Ltd, in consultation with Sheffield Children’s Hospital, to support children with asthma. It uses a monitoring device, (PUFFClicker), that connects wirelessly to the Asthma + me App and monitors medication usage, providing education tips, reminders and incentives.
In this project, 15 children (and their families) will trial Asthma + me with a PUFFClicker and a 3-4 hour education session and let us know what worked and what didn’t using structured interviews and questionnaires. In addition, we will map out the number of patients that could potentially use this solution to self-manage their asthma, with the support of the hospital, until they are ready to be discharged back to their GP.Lay summary of study results: Summary of findings
• It is understood that subjects for the study, both intervention and control, were drawn from patients presenting in the Emergency Department of Sheffield Children’s Hospital with asthma related issues. Baseline analysis of age, PEF and FEV1 data revealed no significant differences between the 2 groups, meaning that they were comparable for analysis purposes.
• For the self-reported data on health care resource use, the descriptive statistics indicate a reduction in resource use after 3 months compared to the baseline, except for outpatient appointments which rose slightly on average. The differences between the control and intervention group were small and there was no statistically significant difference between the 2 groups.
• For the Beliefs about Medicine questionnaire, there was no significant difference between the change in scores between baseline and the 3 month record for either of the 2 scales (adverse consequences and necessity) comparing the control group with the intervention group.
• For the Brief Illness Perceptions questionnaire, both the control and intervention groups had higher mean scores at 3 month compared to baseline, with one exception: this was for the ‘preventers’ item, which was lower at 3 month than at baseline for the control group. The size of differences was bigger for the intervention group than the control for 5 of the 8 items. The biggest increase in scores was for the symptoms item for the intervention group. None of the items showed a statistically significant difference between the control and intervention groups.
• For the knowledge and confidence items, all the analyses indicate there to be no significant difference between the two groups for any of the areas measured. For the confidence items, the descriptive statistics showed both groups to have higher confidence after 3 months than at baseline except for the intervention group having lower confidence around discharge.
• For the CHU9D scores, the intervention group appeared to have a lower utility score after 3 months, whereas the control group had a higher utility value after 3 months compared with the baseline. The differences do, however, appear small but they were statistically significant.
• For the asthma control questionnaire, the control and intervention groups both had lower scores at 3 months compared to the baseline, except for the FEV1 score. At both time points, the intervention group had lower mean scores than the control group. Correlation tests indicate that there is some relationship between the measures, such that as parents become more confident regarding their child’s asthma, they also have more knowledge regarding it, and as asthma control increases, quality of life increases. But the relationships are small to moderate, suggesting that other factors, not measured or summarised in the logic model, may also be important.REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
18/YH/0198
Date of REC Opinion
22 Jun 2018
REC opinion
Further Information Favourable Opinion