Digital Smart Inhaler monitoring in children and young people with high-risk asthma in UK primary care

27 Mar 2025
Background: Children and young people (CYP) with asthma in the UK have the highest rate of severe asthma attacks of any high-income country in Europe. A major obstacle to good asthma outcomes is poor adherence to preventer medication (ICS) and over-reliance on short-acting beta-2 agonists (SABA). We aimed to discover whether a smart inhaler-enabled care pathway in high-risk CYP with asthma is acceptable to CYP/parents and feasible within primary care. Methods: Prospective cohort study (Nov-23-Dec-24) in Leicestershire primary care. CYP (5-16yrs) on the practice asthma register with high-risk asthma (attack in previous year and/or high SABA prescriptions) were invited to attend an asthma review at their practice. Spirometry, FeNO and asthma control were assessed at baseline. CYPs were given a digital smart inhaler (Hailie, Adherium (NZ) Limited) linked via Blue-tooth to the app on their/their parent’s smart phone. Telephone follow-up at 3-months was conducted and face-to-face follow-up at 6-months is in progress. Results: 72 children were recruited; mean age 9.0 (SD 3.1) years, 43 (60%) boys. 58 (81%) were from White ethnic backgrounds, and 45% from the most deprived areas of Leicester/Leicestershire. 68 (94%) were prescribed an ICS inhaler at baseline. FeNO at baseline was available for 40 (55%) CYP, median 39.5ppb (range 5-130ppb). Baseline spirometry was available for 62 (86%), median FEV1%predicted 82% (range 68-123%). The mean asthma control score increased from 19.6 (SD 3.6) at baseline to 23.5 (SD 3.1) at 3 months follow up. Conclusions: Digital smart inhaler monitoring of high-risk children with asthma in primary care is feasible and acceptable to CYP and their carers. Digital smart inhaler monitoring was associated with a substantial improvement in asthma control at 3-months follow-up.

Resource information

Respiratory conditions
  • Asthma
Respiratory topics
  • Inhalers
Type of resource
Abstract
Conference
Brasov 2025
Author(s)
Erol Gaillard 1, David Lo 1, Sander ten Veldhuijs 2, Jacqui Melville 3, Tony Bowden 2, Lesley Danvers 5, Debbie Lee 6, Mayuri Gogoi 1, Irtiza Qureshi 1, Hilary Pinnock 4 1 University Of Leicester, Leicester, United Kingdom 2 Helicon Health Ltd, London, United Kingdom 3 Adherium (NZ) Ltd, Auckland, New Zealand 4 University of Edinburgh, Edinburgh, United Kingdom 5 University Hospitals of Leicester NHS Trust, Leicester, United Kingdom 6 East Midlands Regional Research Delivery Network, Leicester, United Kingdom