Dr Andy Whittamore, Clinical Lead at Asthma UK and the British Lung Foundation, tells HEQ about developments in the treatment of lung conditions.
Dr Andy Whittamore, interview by Rosemary Lobley.
The British Lung Foundation, the ‘only charity looking after the nation’s lungs’, aims to promote lung health and to support research and care for lung-related conditions.
Dr Andy Whittamore, Clinical Lead at Asthma UK and the British Lung Foundation, tells HEQ about developments in the treatment of lung conditions.
What benefits can digital innovation and technology offer in the care and treatment of patients with lung conditions?
The NHS system for people with lung diseases revolves around an annual patient review. Between those annual reviews a patient’s condition may improve or deteriorate; and so technology and digitisation allow the patient to have a bit of empowerment over their own condition. Rather than relying on a once-a-year appointment to touch base, a digital system can allow them to monitor and understand their condition more themselves, and they can actually identify when they are struggling or when they may need more help.
One thing that we have seen more recently in my practice is a digital tool which enables us to identify which patients we may need to see sooner: it takes into account factors like people’s self-reported symptoms, flare-ups, inhaler use and hospital visits; and highlights those patients for a review earlier than their annual checkup. Another key benefit of technology is that it enables us to stay more in touch with our patients. We will send out symptom checkers to the asthma patients in our practice every few months, so that that we can keep a close eye on them and see how they’re doing.
Has the COVID-19 pandemic accelerated the development and adoption of new and emerging technologies in the diagnosis and treatment of lung conditions?
There has been a major shift in the NHS: even though we were already starting to see technology being used for remote consultations, the need to keep our staff and patients safe from COVID-19 has meant that we have done a lot more remote consulting in the past year – not only via telephone, but also by video chat and email. These technologies have not just enabled us to keep in touch with our patients, but the widespread need for remote communication has actually helped the NHS to move forwards to adopt these technologies faster. COVID-19 has shown that patients don’t always have to travel to see somebody; they can be seen in their own space – and that is more environmentally friendly; and it is beneficial in terms of health and safety, because patients are not interacting with other people who may have the flu or COVID. It also means substantially less disruption to people’s day-to-day lives: they don’t need to make a detour after work or travel any distance from their home to have contact with a healthcare professional.
Can you tell me a bit about the Asthma Technology Fund? What technological solutions could the Fund help deliver for patients with asthma?
The Asthma Technology Fund is a £3m fund to help us develop and adopt existing technologies. The idea behind it is that we know there is a great deal of technology development taking place, not just around asthma but other lung conditions; and even outside the NHS. What we are doing is providing those developers with the funding and support to try and adapt those technologies to the people who need it. Asthma UK and the British Lung Foundation have partnered with the National Institute for Health Research (NIHR) and the Engineering and Physical Sciences Research Council (EPRSC), with the goal to help innovators who have developed or want to develop new technologies to find a way to get those technologies into the NHS, where they can help patients.
In asthma care, we have the right inhalers and the right drugs. We have the right information, and patients are able to access the information they need to manage their condition; they know that they need to take medication regularly as prescribed and to be on the lookout for symptoms which can signify that they may be at risk of an asthma attack. Moving forward, the NHS’s long-term plan includes a section based around smart inhalers, which have technology built into them. That technology can take many different forms: the inhaler may recognise when it is being used and link to an app to provide the patient with that information, so they can recognise their triggers and manage themselves accordingly. It might detect pollen or pollution in the air, thereby helping patients to recognise when their asthma might be poorly controlled. It might just be simple things like triggering alerts and identifying a patient’s location when they use their inhaler, so that we can identify hotspots for triggers. Smart inhalers are going to be a real game-changer across the world – we are already seeing examples in the USA of health insurance systems funding these schemes, and some have made their way into European health systems – and the NHS is trying to be at the forefront of this.
Are there preventive or protective measures which can be taken to lessen the risk of contracting lung disease in later life?
We know that there is a cohort of people with asthma who only get it later in life: that can be due to hormones or it can be related to long-term exposure to triggers such as pollution and smoking. There are other lung conditions, such as chronic obstructive pulmonary disorder (COPD), which are triggered or exacerbated by smoking and chronic exposure to air pollution. Illness prevention measures can include preventing air pollution, supporting people to give up smoking, and helping them to maintain a healthy lifestyle generally; as we know that exercising and having a good diet can protect people against some diseases.
Has the impact of the pandemic on healthcare services affected the level of support available for people with lung issues?
Asthma UK and the British Lung Foundation conducted a survey of 8,000 people with lung diseases, and 35% of respondents said that their care had been delayed or cancelled due to the first national lockdown in March 2020. If we don’t look after people with restrictive diseases now, then they will be more strongly affected by flu, the cold weather and other triggers, as well as COVID-19; and that creates even more work for the NHS. It is really important not just to care for people who have these conditions, but also to protect the health services from being impacted by a surge of patients whose lung conditions have been triggered or exacerbated by winter-related issues.
Dr Andy Whittamore
Clinical Lead
Asthma UK and the British Lung Foundation
www.blf.org.uk
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