Smartwatch-based asthma alert set to revolutionise care

A smartwatch could revolutionise asthma care by alerting asthmatics to an impending attack, say scientists at Waipapa Taumata Rau, University of Auckland in Asthma Week 4 to 9 May.

With the awareness week, the researchers want to offer hope to the one in seven children and one in eight adults affected by asthma, with Māori and Pacific people facing higher risks of serious illness and hospitalisation.

“We are excited to be testing what promises to be the first breakthrough in asthma care for fifty years,” says lead researcher Associate Professor Amy Chan, head of the School of Pharmacy in the Faculty of Medical and Health Sciences.

“Asthma care has always been reactive, but the way I explain this to patients is that this could be like a smoke alarm in your house. You want the alarm to go off before the fire starts.”

The smartwatch would monitor a range of signals and feed information to an app, which would send an alert when the risk was high. That would prompt the patient to consult and follow their asthma action plan – the personalised instructions their doctor or nurse has given them for what to do if their asthma worsens.

Asthma attack prediction using smartwatches

In the first stage of the research, more than 200 people with asthma wore smartwatches every day and tracked their symptoms, alongside notes on asthma attacks, to see whether there was a digital fingerprint that could predict an attack.

From this data, the team developed an algorithm to predict the likelihood that a person will have an asthma attack in the next seven days.

The algorithm performed better at predicting attacks than standard care tools such as self-reported symptoms and peak flow. This was intentionally developed with strong Māori and Pacific representation, as these groups are two to three times more likely to be hospitalised with asthma than other New Zealanders.

The researchers are now planning a randomised controlled trial – the gold standard – to test the smartwatch-informed alert in 250 people with asthma over 12 months. Both groups will receive standard asthma care, but half will receive a risk score showing their likelihood of an asthma attack based on data from their smartwatch while the other half will not.

“The only difference is access to information about their potential risk,” Chan says.

“That means we can truly test the secret sauce – or the magic ingredient – which is the risk score.”

The research, which will test the accuracy of the alert system as well as its impact, has been partially funded by the Auckland Medical Research Foundation and Return on Science, with hopes of securing further funding.

Personalised asthma treatment trialled in Māori and Pacific people

A second research project, which recently received $1.4 million funding from the Health Research Council, aims to improve asthma management and reduce unnecessary steroid prescriptions for Māori and Pacific people with asthma.

This trial, run in collaboration with the National Hauora Coalition, will involve a finger-prick blood test and a breath test when a patient visits their GP following an asthma attack.

Some asthma attacks are driven by immune cells called eosinophils, which respond to steroids, while others have different causes, such as viral infections, and may not respond as well to steroids.

“We know Māori and Pacific people often have worse asthma symptoms, so they’re the ones who have been getting far more steroids,” Chan says.

“But we also know the risks of diabetes, stroke and cardiovascular disease – as well as obesity and mood disorders – are higher in these populations and worsened with more steroids.

“What we are testing is whether steroid treatment can be personalised depending on the type of asthma attack a person has, rather than giving a standard ‘one-size-fits-all’ steroid course.”

Current best practice recommends people receive no more than one gram of corticosteroids over their lifetime, yet our research found many New Zealanders with asthma are prescribed this amount within a single year, Chan says.

This study is co-led by Associate Professor Anneka Anderson in Te Kupenga Hauora Māori, also in the Faculty of Medical and Health Sciences at Waipapa Taumata Rau, University of Auckland.

It aims to be a globally leading trial of a rapid point-of-care test to support personalised asthma care in the community.