A child with asthma uses a smartphone-linked device to monitor their breathing at home, sending data directly to their clinical team in real time. This matters because asthma care for children is often reactive—parents only discover a problem when symptoms escalate to an emergency visit. Current integrated care pathways exist but lack tools for continuous, remote monitoring of both symptoms and treatment adherence. The research fills a gap in evidence about whether adding digital technology to these pathways can prevent crises before they happen. If the trial succeeds, the combined technology-enhanced care could reduce emergency hospital visits, cut NHS costs, lower family stress, improve school attendance, and prevent deaths. The technologies being tested include remote wheeze monitoring and remote treatment monitoring. The project also assesses cost-effectiveness, usability, and how well the system works in real-world NHS settings. For a senior programme manager, the key takeaway is that this is a pragmatic, three-arm randomised controlled trial designed to produce the kind of implementation-ready evidence the NHS needs to adopt digital asthma tools at scale.
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Research question Can outcomes for children with asthma be improved by enhancing integrated care with technology? Background This project seeks to improve outcomes among children with asthma by enhancing newly developed integrated care pathways with technology for improving remote symptom and treatment monitoring. If successful, the combined technology-enhanced integrated care pathway has the potential to transform outcomes for children with asthma. We will provide high quality evidence addressing important gaps in knowledge about effective interventions to improve prevention, self-management, risk stratification, treatment, and monitoring, which are key to improving health and wellbeing outcomes for children with asthma. Effectiveness, cost-effectiveness, and implementation evidence will support NHS adoption. The technologies we will test are designed to: 1) improve symptom monitoring 2) improve treatment monitoring and adherence and the intervention is designed to: Prevent emergency care (the primary outcome) and other health service use Reduce associated NHS costs Reduce associated family stress Improve health and prevent deaths Improve school attendance and participation Aim: to assess outcomes for children with asthma using technologically enhanced integrated care. Objectives: To assess the effectiveness of integrated care for asthma augmented with remote wheeze monitoring To assess the effectiveness of integrated care for asthma augmented with remote treatment monitoring To assess the reach, effectiveness, adoption, implementation, and maintenance of technology use To investigate patient, parent/carer, and staff experiences To assess technological usability and sustainability To assess cost-effectiveness and model long-term cost-utility Methods We will conduct a three-arm randomised control trial testing each technological component against control, for robust evidence of effectiveness, with nested studies to investigate process, behaviour change, health economics, and technology acceptability. 4 work packages comprising 1) Design, 2) RCT, 3) Nested studies on process, implementation, technology, and health economics, 4) Engagement and Dissemination Timelines The project lasts 32 months, beginning February 2022, concluding September 2024.
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