Asthma is the commonest chronic childhood condition affecting 1 in 11 children. Acute asthma attacks remain a leading cause of unplanned hospital admissions, emergency visits and missed schooldays. Early recognition and management of deteriorations in asthma control can prevent attacks and emergencies. Albus Health invented a contactless and automated table-top device called Albus Home. Employing advanced signal processing and artificial intelligence (AI) algorithms, the multi-sensor platform monitors a range of physiological metrics (such as respiratory rate and cough) and indoor environmental metrics (such as temperature, humidity and air quality) without anyone having to do or wear anything. This enables continuous, objective and accurate monitoring for any patient and for as long as needed, without burdening them. The Oxford AHSN team conducted a feasibility study, speaking to key stakeholders along the care pathway to assess the clinical needs, user requirements and perceived usefulness of the Albus Home monitoring device in the severe asthma pathway for children.
What is the challenge?
More than one million children in the UK currently receive treatment for asthma. The estimated financial burden of asthma on the NHS is at least £1.1 billion annually. Acute asthma attacks are a leading cause of unplanned healthcare use, in particular for children with severe asthma who can have multiple attacks each year. Uncontrolled asthma can have a detrimental effect on a child, causing permanent deterioration in lung function, missed schooldays and decreased quality of life. The impact on parents/carers is significant too.
What did we do?
The Oxford AHSN carried out an initial literature review to explore the evidence base surrounding paediatric asthma management and identify the current care pathway in the NHS. In addition, a schematic diagram of the current and proposed asthma management pathways was developed in collaboration with clinicians. The Oxford AHSN also facilitated an online workshop which brought together key stakeholders to discuss the results and implications of a prior feasibility study to assess the utility of a paediatric asthma home monitoring device, barriers to adoption and how they could be overcome. The Oxford AHSN feasibility study evaluated the technology’s utility in the paediatric asthma care pathway. The key objectives of this study were to assess the potential impact of the Albus Home monitoring device in a home setting to prevent exacerbation and the feasibility of adoption in the care pathway. This project was funded by the National Institute for Health and Care Research (Artificial Intelligence, Prediction and Prevention of Asthma attacks in Children AI_AWARD02005) and NHS England.
What has been achieved?
Stakeholders from the evaluation reported there were significant limitations with existing tools (such as symptom diaries and peak-flow tests), in particular of poor adherence with most patients and families not using them, and unreliable results for children even when used. Stakeholders identified several potential key benefits of implementing the contactless and automated Albus Home device for asthma monitoring including:
- Improved patient outcomes – identifying early warnings, along with timely interventions to prevent emergencies (reducing morbidity and mortality) and enable optimum recovery.
- Healthcare cost reduction and improved operational efficiency, such as reductions in unplanned healthcare and the financial burden on the NHS, and the optimising of medications for patients.
- Improved long-term management – using objective data to establish a baseline for their patients and identifying deviations and variations of asthma control.
- Improved patient experience – improved symptom management and prevention of attacks.
- Improved presentation of risk – notifying patients/parents/clinicians and prompting early intervention and improving asthma care management.
What people said
“It has been fantastic to work together with the Oxford AHSN so far in this exciting project. The AHSN team has brought a collective wealth of experiences and expertise in helping implement and scale innovations within healthcare. Working with the AHSN has helped ensure thorough and diverse stakeholder input from the beginning of the project, helping to understand potential challenges to adoption that could be proactively addressed during the R&D stage. Moreover, understanding the clinical pathway and health economic evidence requirements for successful future adoption was helpful in planning the clinical studies so that the key data is collected. We look forward to continuing to work closely through the rest of the project!”
Dr William Do, Medical Director, Albus Health
A clinical study is currently running at two leading paediatric asthma centres, Birmingham Children’s Hospital and Royal Brompton Hospital, where children with severe asthma are actively being recruited, to collect evidence and data for evaluating the performance of the Albus system. The Oxford AHSN will carry out a health economic analysis once clinical study data is collected to support the adoption of the Albus Home device in the paediatric severe asthma pathway.
Mamta Bajre, Lead Health Economist & Methodologist: Mamta.Bajre@oxfordahsn.org