Elderly man using an inhaler

Digitally transforming asthma management

  • Research

Asthma is one of the most common chronic lung conditions in the world, and using inhalers correctly is key for controlling symptoms. Yet doctors often don’t have reliable information about whether patients are using their inhalers effectively.

Enter INCA, a digital health device developed at RCSI University of Medicine and Health Sciences and Trinity College Dublin. The INCA device attaches to an asthma sufferer’s inhaler and measures when and how well they use it to deliver the corticosteroid medicines into their airways. With this kind of information, doctors are on a more solid footing when it comes to prescribing medication and helping patients to manage their symptoms.

To measure the effectiveness of the digital technology in helping to control asthma symptoms, the INCA SUn study, led by RCSI, recruited more than 200 adult patients with severe asthma from clinics in Ireland, Northern Ireland and England. All of the patients received education about inhaler use, and around half of them then attached the INCA device their inhalers. The INCAs tracked their inhaler use over time by measuring physical vibrations or acoustic signatures as the patient inhaled medications, and doctors could then download and examine this information.

The upshot? It worked. In the group that used the INCA device, more people stuck to their prescribed medication regime, and many of them could control of their asthma without the need for additional medicines. The device saved money too – many patients needed less medication to control their asthma over time as they were using it effectively, and fewer patients needed to be stepped up to more powerful and expensive biologic medications to control their symptoms.

The findings represent an important step towards digital technology being used more widely to support patients with asthma on their inhaler technique and use, and to offer their healthcare teams more objective information about how the inhalers are being used.

The INCA SUn (Inhaler Adherence in Severe Unstable Asthma) study was carried out though the RCSI Clinical Research Centre and was funded by the Health Research Board, Medical Research Council, INTEREG Europe and an investigator-initiated project grant from GlaxoSmithKline. Collaborators included University College Dublin, University of Groningen, Trinity College Dublin and King’s College London. The full findings are published in The Lancet Respiratory Medicine.

With the support of Enterprise Ireland, Professor Richard Costello has created an RCSI spin-out company called Phyxiom, which is translating the learnings from INCA-SUn into an AI platform that aims to transform the clinical outcomes of patients with uncontrolled asthma.

RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.