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

Clinical Research Results Abstract Aim: Traditionally, clinicians assess, manage and support patients during face-to-face consultations. In the COVID pandemic, patients have had to rely on remote consultations to help them to live with their conditions. We aimed to explore how a connected system (A4A+) with smart devices (smart-inhaler, smart-watch, smart peak flow meter) could support asthma self-management.Methods: A4A+ collected data from smart devices on an app that could be shared with practices in the form of a pdf that could be attached to patients’ electronic health records. We recruited 10 asthma patients (range of age/gender/asthma experience/action plan ownership/Apple/Android user/technological competences) via social media, observed their usage of the system over a month (December 2020-February 2021), and undertook baseline and exit interviews. We interviewed one patient’s asthma nurse and three GPs on acceptability of the system and their views on the report format. Thematic analysis used the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Descriptive analysis of usage data enabled triangulation of findings. Results: 7517 self-management data-points (asthma symptoms, PEFR, inhaler usage, exercise intensity, heart rate, sleeping pattern, body/air temperature) were collected from 10 patients though recording reduced over the month. Patients felt ‘positive’, found it ‘easy’ to use the system and chose to use devices they thought were “accurate”. Monitoring adjustments to medication, having asthma (or COVID) symptoms triggered and motivated them to adopt the system. Most patients chose to monitor their reliever inhaler rather than the preventer. Clinicians want to have an overall asthma score/status and reliever usage on the report. Conclusion: Accelerated by COVID, a connected system could enable flexible digital approaches to care by providing self-management data to support remote consultations. However, providing users with confidence in the ‘accuracy’ of systems is needed to maintain motivation to use the system. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest CyH has received grant funding from the MRC CiC (ref: MRC/CiC7/71) to plan and carry out the study works. BM and HP have received grant funding from Philips NV. MB is Managing Director of Tactuum Ltd. Medical International Research and Smart Respiratory Products Ltd provided free smart peak flow devices for this research. Findair and Polar Electro (UK) have provided their apps and API connections to the A4A+ system. References and Clinical Trial Registry Information