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Bevan Exemplar Cohort 4 Projects

Will adolescents with Asthma engage with technology to improve condition self-management?

Victoria Richards-Green

Aneurin Bevan University Health Board

This Bevan Exemplar project engaged with young asthmatic patients at a GP surgery to encourage the use of an app to support basic care.

Background

The UK has one of the highest asthma death rates across Europe and the provision of care varies across the UK; Wales ranks lowest with 68% of people not receiving basic care.

Two thirds of UK asthma deaths are preventable, with the provision of basic asthma care stopping asthma attacks, keeping people out of hospital and saving lives.

Basic asthma care involves:

  • Inhaler technique training
  • A written asthma action plan
  • An annual asthma review

There is a commercially available mobile application that can provide these three elements and more.

Adolescents account for the biggest proportion of asthma related hospital admissions; as these adolescents embrace new technologies, healthcare services can use such applications to address health needs and increase the levels of basic care received by these patients.

Aims

  • To get adolescent asthmatics within a selected GP surgery to engage with and use a commercially available web-based application, to improve the basic level of asthma care for adolescents
  • To assess the engagement with app technology for healthcare, in order to structure future roll out.
  • Evaluate if the use of an app for asthma self-management can reduce hospital and GP contacts for asthma exacerbations.
  • Consider the role of the Physicians Associate within a GP surgery, for the management of stable asthmatics.

This project fits with the prudent healthcare model by

  • Co-production – involving patients more in their own care by promoting self-management.
  • Patients with the greatest need first –Patients that are not controlled can be flagged to the surgery so these are seen before those who are well controlled.
  • Doing only what is needed – as there are no additional unnecessary interventions.
  • Reducing inappropriate variation and provided health equality – as it would eventually be offered to all asthma patients regardless of location.

Challenges

  • The process of approval for new technologies; knowing who to speak to and at what point in time.
  • In order to overcome this, links have been made with the multiple departments within the health board, to come up with a flow chart for the implementation of future technologies.
  • This will be shared across the health board to prompt due diligence and process for all implementations going forward.

Outcomes

  • The team continues to collect data on the impact of the asthma app on patient care. This data will be available in 2021 following an analysis of patients over a year, to allow for the seasonal variation seen in asthma symptoms.
  • Through development of a guide for the “implementation of tech innovations” the team can reduce time to initiation, demonstrating overall savings in time and money whilst encouraging innovation.
  • The roles of different health care professionals in the management of asthma is undergoing analysis, to develop a tiered system of patient management based on skill levels. This releases time for more qualified staff to review the sicker patients.

Next Steps

  • Evaluate the data to demonstrate how to engage with technology for healthcare and what benefits this can bring, not only for patients but for healthcare providers.
  • Once established, roll out app technology for self-management to the whole health board in primary and secondary care settings.