Love Your Lungs Week

Following Love your Lungs Week, 21 – 27 June 2022, KHP Women and Children’s Jasmine Nguyen spoke with Dr Kirsty Logan about her work improving asthma outcomes for children.

Formerly Breathe Easy Week, Love Your Lungs Week is an initiative started by the British Lung Foundation to raise awareness about lung conditions and encourage people to focus on lung health. Hear how King’s Health Partners (KHP) Women and Children’s Health is tackling asthma in children across London through the TEAMcare project:

Please introduce yourself and describe your interest in clinical epidemiology

I’m an Epidemiologist by training and my previous roles have included a research role in paediatric infectious diseases at the UCL Institute of Child Health and a research and clinical trial management role within the Children’s Allergy Research Group at King’s College London (KCL).

I am currently working as a Senior Research Fellow within King’s Health Partners Women and Children’s Health, specialising in clinical epidemiology, clinical trial design/management and quantitative research methods. This role crosses a lot of health disciplines and complements the clinical and research work done throughout King’s Health Partners.

Can you tell me a little more about the Technology Enhanced integrAted asthMa care (TEAMcare) project and what your role is for this?

This is a clinical trial run by two respiratory experts, Dr Ingrid Wolfe from KCL and Professor Johnathan Grigg from Queen Mary’s University London. Their goal is to improve asthma outcomes for children living in three London boroughs – Southwark, Lambeth and Tower Hamlets.

There has already been a shift on how asthma is dealt with in Southwark and Lambeth. Ingrid’s team has developed and tested a process of early identification of children who have poorly controlled asthma and established a specialist service that runs in the community to give care to those children. 

The results from this trial could lead to further improvements in children’s asthma care by incorporating the use of technology into this specialist service. Some of the children within our clinical trial will receive some new technologies to see if that will improve their asthma outcomes.

There are three groups in the trial and participants will be allocated to a group randomly, they will not be able to choose which group they are in. A control/comparison group will be receiving the same care as if they hadn’t been taking part. There are then two technology groups: one that will receive a smart sensor that sits on top of their normal inhaler and tracks the use of medication as well as messaging via an app to remind them to take their inhaler when it’s due. With this, we hope that it will improve their medication intake which will result in better control of their asthma. The other technology group will receive a device that records their breathing sounds. This device will help them identify wheeze symptoms and determine if they might need to seek help or take their inhaler. Ultimately, we want to prevent those acute asthma attacks in children because that is what leads them to the emergency department and that’s when their future health and lives are in danger.

Since England has the highest mortality rates from respiratory diseases, how do you think this project will help combat this issue?

If the use of these technologies in children’s homes can bring down the number of times unscheduled or emergency healthcare visits for asthma treatment occur, then this is an important step in improving asthma outcomes for children.. We can then find ways to incorporate this technology as part of our everyday care of children with asthma.

Can you further explain how TEAMcare proposes to improve the life expectancy gaps of socioeconomically deprived areas in England? 

This trial will be running for 2 years, and we will be running across three boroughs within London: Southwark, Lambeth, and Tower Hamlets. We are trying to enroll 1500 children over the trial period. Alongside this, this will look at how the technologies are tolerated by patients, their parents/carers and healthcare professionals. By collecting this information we can also inform discussions with commissioning bodies should the devices be successful in improving asthma outcomes meaning they could become part of standard care more quickly.

These three boroughs are diverse communities with high levels of deprivation. Improving the outcomes for asthma in these areas is not straightforward, there are a lot of factors to consider, but embedding the trial and potential future use of these technologies within established specialist care in the community gives us a good chance of success.

The nice thing about this trial and technologies that we might be able to bring into standard care is that they are used in the home. This will allow the patients to have control over their own interventions without additional hospital visits or new medications.

By doing this trial in areas with significant levels of deprivation, we can be reassured that if the technologies are successful in improving asthma outcomes, these interventions work for some of the children that need them most.

Do you believe that enhanced remote asthma monitoring in children and young people results in fewer asthma attacks?

We don’t know yet, but these are devices that are already on the market and have been shown to work in other populations. From the work that has been done before, we have reason to believe that it will make a difference, we just need to make sure they make a big enough difference that it’s worth using them more widely.

Why do you think it so important for children and young people to be included in this project and how will it help them throughout their lifespan?

The age of children in this study is 6-16 years, so many children, especially on the older end of this spectrum, will be starting to take control of their own health and asthma. With the technologies in this trial, they have something that they can control using their phones at home and giving them a sense of control is a positive thing and might also help improve asthma outcomes. Additionally, participating in research for children can be an empowering experience. It shows them that we care about their health and we care about their opinions, and we want children and young people to feel important and listened to.

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