Exploring patients’ use of reliever inhalers for asthma monitored using Smart Rescue: a qualitative study. (ID 674)
University of Oxford
Abstract
Background and Aims: High reliever inhaler use in asthma is associated with adverse outcomes. Various HealthTech strategies have been proposed to help reduce this. Smart Rescue is a device which attaches on top of a Metered Dose Inhaler. It records the user’s puffs and displays them graphically on a Bluetooth-linked Smartphone app.
This study had two aims:
i. To explore drivers of reliever inhaler usage with reference to individual visual records.
ii. To explore how using Smart Rescue has impacted asthma self-management.
Methods: Smart Rescue sent out app notifications about the study. Online qualitative interviews focused on the personalised visual graphs and explored experiences with the app. Reflexive thematic analysis was used to identify key themes and insights.
Results: 12 participants (73% female), Smart Rescue users for 4-12 months, were interviewed. Participants had a median Asthma Control Test score of 15.5/25 (range 11-22).
In addition to well-established triggers such as cold weather, the biggest driver for high reliever use at particular times was coincidence of several factors together, particularly normally minor physical triggers being magnified by psychosocial factors such as anxiety or feeling unsupported.
Participants reported several ways in which the Smart Rescue app supported their asthma management. Firstly, the app’s reminder function was considered helpful in prompting regular use of preventer inhalers, as well as knowing when their inhaler would run out. Secondly, users valued the ability to visually track their asthma control and observe patterns or improvements over time. Thirdly, the app was seen as a useful tool during asthma consultations, providing a structured basis for discussion with healthcare professionals. Notably, some users perceived the app as more useful than their standard written asthma action plan, highlighting its potential to enhance self-management and clinical interactions.
Conclusions: Our study shows that Smart Rescue is a promising tool to support patients’ asthma self-management. Limitations include recruiting active users who may have been provided with Smart Rescue due to poor asthma control and/or high reliever usage, so findings may not be generalisable to the whole asthma population. Further research into clinical and cost-effectiveness is needed before widespread implementation into NHS services.
Funding: We are grateful to Smart Respiratory Ltd for providing us with anonymised data about Smart Rescue usage and for promoting the study via the Smart Rescue app. This was a medical student project which received no formal funding, and none of the co-authors have received any funding or payments from Smart Respiratory Ltd. All design, analysis and interpretation have been conducted independently by the co-author team.
Conflicts of interest: Helen Ashdown is co-lead of the Respiratory Theme, and receives funding from, the National Institute for Health and Care Research (NIHR) HealthTech Research Centre for Community Healthcare at Oxford Health NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. In this role she leads studies and evaluations involving respiratory technologies, where these have been provided at reduced price or free-of-charge by the companies but she has no financial interest in these companies, or direct payments from them.
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