Asthma app which cuts risk of attacks to be made available to NHS patients

An AI app which could help asthma patients avoid life-threatening attacks by advising them when to properly use their inhalers is being rolled out more widely across the NHS after a successful pilot.

More than a million people with asthma in the UK are at risk of serious attacks because they aren’t using their inhalers properly, according to a report in 2022.

Now, an AI app tested with NHS patients in Suffolk has been found to help them manage their conditions better, by having an average of four conversations a day with them over a six-month period.

Using the same AI technology as Amazon’s Alexa, the app, known as Aide, guides patients through their medication use with texts and graphics.

Crucially, it was found to improve people’s inhaler use – stopping them overusing emergency inhalers and underusing prevention inhalers – which is key to controlling symptoms and preventing attacks.

Dr Neil Macey, the Suffolk GP who led the pilot, said the app showed “great potential for asthma management and many other areas of clinical medicine”.

Ian Wharton, who runs Aide Health, said the study “paves the way for a potential 10 per cent reduction in severe exacerbations” – which commonly result it hospitalisations and A&E visits.

This is because nearly three quarters of those in the pilot were using their inhalers “appropriately” by the end of the study – compared to about 50 per cent among asthma sufferers in general.

However, he stressed that much bigger clinical trials were needed to determine the precise benefits of the app, which may show it to be more or less effective that the smaller scale pilot suggested.

The pilot study involved 194 asthma patients at seven GP practices in Suffolk and took place over six months.

The app identified those patients who overuse their “reliever” inhaler – defined as more than twice a week – finding that 43 per cent were “overmedicating”. Blue inhalers are for use in emergencies – with symptoms such as coughing and wheezing.

The app also helped people with their preventer inhalers – the “day-to-day” brown devices which people often don’t use enough and are key to preventing asthma attacks. These should be used every day to keep down inflammation and swelling in the airways from triggers such as dust or pollen.

A 2022 survey from Asthma + Lung UK, of more than 8,000 people with asthma, suggests one in five people with the condition are using their reliever inhaler too often, getting through six or more every year – triple the number experts suggest. When applied to the general population of people with asthma this equates to more than one million people.

“Overusing a reliever inhaler puts people more at risk of an asthma attack, hospitalisation and even death, because their asthma is less likely to be under control,” Asthma + Lung UK said.

The study also found that 50 per cent of patients did not have an asthma action plan – with the app helping them to develop one and again reducing the potential for an asthma attack.

Making and sticking to an asthma action plan is associated with a 70 per cent reduction in mortality, according to a 2017 published in the European Respiratory Journal.

Dr Erika Kennington, head of research and innovation at Asthma + Lung UK, said: “As this tool is still on trial, it’s not yet possible to draw a firm conclusion on how promising it is. But we do know that currently people living with asthma do not have the right tools to manage their lung condition in a way that is beneficial to them.

“Asthma is a condition that requires self-management in order to stay well, so having a tool such as an app to help manage this could prove really useful in good condition management, but requires trials like this to test if they work effectively for people,” she said.

Dr Macey, of Stowhealth practice in the Suffolk town of Stowmarket, added: “We were pleased with the high retention rates, which we feel are a testament to its usability and use of natural language. We were pleasantly surprised by the frequency with which some patients were engaging with Aide to log their medication use and symptoms. The apparent increase in medication adherence rates in users was obviously a huge positive to.”

Following the pilot in Suffolk, of GPs overseeing the care of about 130,000 patients, the app will now be offered at two more primary care networks – in Cumbria and Northumbria, covering around 250,000 patients between them.

The developers of the app are also in discussions with other primary care networks around England, including several in London, to use the app for diabetes management as well as asthma.

They are also in the process of adding chronic obstructive pulmonary disease (COPD) and cardiovascular disease management to the app (in addition to currently offering of asthma, diabetes and hypertension) and hope these will be available in the next six months.

‘I used to forget to take my medication’

Jessica Stone, from Debenham in Suffolk, used to have an asthma attack around once a week in the winter and spring while in the summer it could be as often as every day or couple of days.

But since she started using the Aide app at the beginning of the year, she says she hasn’t had a single one.

“It has been absolutely amazing,” she said. “I have the odd asthma symptom but I hadn’t had an asthma attack in months since I was using this app – because now I’m keeping records and getting reminders to take my medication (inhaler and a daily tablet) and I’m taking it and then it’s preventing me from having a full blown asthma attacks.

“I used to forget to take my medication a lot more. The morning inhaler is the more important one because that prevents it for the rest of the day. It’ll ding my phone and remind me to take them at the times that I’ve set. So I’m on top of it – it’s the most controlled my asthma has been because of this app.

“I’ll be carrying on using the app for the rest of my life – because my asthma’s not going to go anywhere.”