Abstract

Background: Previous studies showed that signs of poor asthma control could be recognised 7-28 days before the patient presents with an attack1,2 and reduced lung function can persist up to 28 days after.3 Electronic surveillance, particularly post-COVID, assists patients and clinicians effectively monitor and manage attacks early and in the post-attack phase. We present some example data demonstrating the effectiveness of an electronic solution for remote monitoring.
Method: Smart Respiratory Products Ltd applications and sensors provide convenient technology for patients to self-monitor their Peak Expiratory Flow(PEF), symptoms(ACQ and ACT) and reliever use. The Smart Peak Flow(SPF) and Smart Rescue sensors send timestamped data(PEF and inhaler actuation) to smartphone apps, with secure anonymous cloud backup. Prediction of next day PEF zones provides early indication of asthma degradation4 by calculating CompEx diary events, a novel composite surrogate measure of moderate/severe asthma attacks.5
Results: Over 1,000 patients are using these products in the UK and Europe and analysis of data collected provides information for clinicians, clearly demonstrating deteriorating control. In Figure 1, PEF variability is evident 27 days before the CompEx event and hasn’t returned to the best level after 30 days. Symptoms and SABA use increased from baseline 20 days before the CompEx event and only returned to baseline after 20 days.(see Figs 2 and 3)
Conclusions: Electronic monitoring using Smart Respiratory products provide timely early warnings of poor control for patients and clinicians which could be used to initiate early interventions to prevent attacks as well as a method for post-attack monitoring
References:
1. Levy et al ERJ 2021; 58: Suppl. 65, PA3397
2. Tattersfield AE et al Am J Respir Crit Care Med. 1999;160(2):594-9.
3. Ferrer A et al 1993;147:579-84.
4. Sakkatos P et al. ERJ. 2020; 56: Suppl. 64, 155.
5. Fuhlbrigge AL The Lancet Resp med. 2017;5(7):577-90.