Modern medical science has made remarkable progress in the treatment of asthma. Inhalers containing steroids are particularly effective in preventing an asthma attack. But getting people to take these preventive medications long-term remains a challenge.
Because asthma is a chronic condition, many people find it difficult to take their medications regularly, due to busy schedules or because medications may not seem to work right away.
One potential solution lies in digital technologies that can reduce the risks associated with not taking medications as prescribed. These technologies include SMS reminders, web applications, interactive voice response systems and smart inhalers.
The benefits could be considerable, considering that asthma is one of the most common health problems. It affects as much as 339 million people worldwide. New Zealand has one of the highest asthma rates, with one in seven children and one in eight adults diagnostic.
Asthma attacks are also the most common cause of days missed from school and work for people with the disease. In the UK it is valued one person has a life-threatening asthma attack every ten seconds, with similar data from New Zealand. Asthma mortality is highest for Maori and Pacific peopleswith rates 4.3 and 3.2 times higher than for the other groups.
Although there are inhalers that work well on immediate symptoms, preventer medications are essential for long-term asthma control. These should be taken as prescribed, often once or twice a day. So-called “non-compliance” with these diets is a major health issue and can lead to more symptoms and attacks.
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Medication adherence strategies
Compliance is therefore very important to reduce the risk of death. With increasing investment in digital technologies designed to improve health, asthma research is focusing on improving the use of existing medications and therefore improving outcomes.
Research in New Zealand has shown “smart” inhalers – devices that monitor when doses are taken and can provide reminders and feedback – improved medication adherence by 50% and better control in children with asthma.
But we still don’t know if digital technologies in general can improve the situation for all people with asthma and, even if they do, if it will have a positive impact on asthma symptoms or attacks.
To learn more, we reviewed all randomized controlled trials of digital technologies and their impact on medication adherence in asthma. We have found 40 studies worldwide, with a collective sample of more than 15,000 adults and children with asthma.
By pooling data from all the separate trials, we were able to measure whether people who used digital technologies to improve their medication regimen had better adherence – and fewer asthma symptoms and attacks – than those who didn’t. not done.
How digital technologies can help
In short, digital technologies box work to improve the intake of asthma medications.
On average, 15% more people took their medications as prescribed when they had the technology, compared to those who did not (who took 45% of the prescribed amount of their medications).
This 15% increase may have a significant impact on people’s asthma management because more regular use of medication can reduce symptoms and reduce the risk of attacks.
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Looking at all the studies, people with access to digital technology had fewer asthma symptoms and, on average, half the risk of asthma attacks compared to people who did not have access to technology. These benefits could reduce the risk of asthma-related death.
We also found that people who had the technology had better quality of life and better lung function, although the effect on lung function was small and may be of limited clinical significance.
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Daily Asthma Care
For people with asthma who struggle to take their medications regularly, digital technologies are likely to help improve their medication intake, which in turn can reduce asthma symptoms and attacks.
But we need more research on how these technologies can be integrated into routine asthma care. The available studies don’t tell us enough about the effects on time away from work or school, the cost-benefit, or if there are any harmful outcomes.
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Additionally, digital technologies may not work for everyone. While research shows that users are generally accepting of technologies, people didn’t complete the full study in about 25% of the studies we looked at.
Some technologies may also work better than others. We found that smart inhalers and text messaging systems seemed better at improving medication intake than other types of technology. But the small number of studies means we can’t be completely certain that these technologies actually work better.
Future technological potential
Digital technologies are constantly evolving and are likely to play an even greater role in future asthma care. Devices like smartwatches can monitor changes in a person’s physiology in real time.
These changes could be used to plan a change in a person’s risk of asthma attacks when combined with information from the environment such as changes in temperature and air humidity.
This risk prediction is the subject of ongoing research funded by the Auckland Medical Research Foundation and Health Research Council.
If it proves effective, we could see a substantial change in asthma management. Users may one day be able to monitor their asthma control status simply by looking at their phones.
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