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Tackling respiratory disease with home-based solutions could improve lives of 6 million
Respiratory diseases such as COPD, Bronchiectasis and Asthma affect 1 in 5, making it the 3rd biggest cause of death in the UK. NHS provides 1 million hospital bed days for sufferers, spending an estimated £4.7 billion a year treating patients.
A tailored suite of simple medical devices, internet connected iPads and training in how to use them will be provided to 30 volunteer patients from the Portsmouth area. In the study, volunteers will measure their own parameters of health such as: lung function, levels of physical activity, oxygen levels in the blood and even their weight using devices, which then automatically send the information to a secure dedicated website, via the iPads issued to them. Volunteers will also provide samples of sputum, which will be analyzed later at PHT using a new test developed by Aseptika that measures the level of activity of certain bacteria.
The 3 collaborators have come together to test the idea that this information when combined, can be used to predict flare-ups of infection 10-15 days before hospitalisation is eventually required.
Future services might include a self-care plan in which patients are educated to monitor and interpret their own signs of impending exacerbation because the technology is being developed to be simple enough for everyone to use correctly - with a little education, training and support from their clinical care team.
The emphasis of the solution being developed and trialed is patient empowerment, self-management and giving greater control to the patient and their family members who care for them.
With the digitalised information recorded and made accessible to a diverse range of professionals involved in supporting these patients, the Aseptika system can also be used to provide remote support, monitoring, advice and health coaching during weekends and evenings, providing a continuum of care at home, which cannot be delivered through face-to-face contact because rising demand is fast outpacing the resources that are available.
SElf-management checks to predict exacerbatioNs of Pseudomonas aeruginosa in patients with long-term reSpiratORy conditions or SENSOR, is funded through Aseptika, via a contract with NHS England’s SBRI Healthcare (http://www.sbrihealthcare.co.uk/
Aseptika is working closely with the clinical research team at PHT and the NHS South Central Research Design Service as well as academic staff from the School of Health Sciences and Social Work at UoP. Aseptika is funding positions for a research nurse and a laboratory technician based at PHT, the research by UoP and is providing its Activ8rlives products to volunteer patients – with an iPad. The 3 teams are also collaborating to develop a dedicated App to meet the specific needs of the people of Portsmouth who take part in the SENSOR study programme.
Commenting on the goals of the collaboration, Professor Anoop Chauhan, Research Director and Chief Investigator at PHT said:
“Everyone in healthcare knows the challenges that lie ahead – an ageing population, lifestyle-related ill health, increasing demand for services and constrained budgets. We have pioneered the use of self-care plans in Portsmouth and these are very popular with patients because following them reduces the number of visits they have to make to the hospital. We have also researched the impact of providing 24/7 care at home in the surrounding area and this has been proven to help patients stay healthy, reducing the number of emergency admissions, but it is very expensive to provide through face-to-face contact with the patient.
In the past there have not been the simple technologies and tools to enable the patient and their families to help themselves when they need it. Ideally, we want these same tools to also communicate this information to us at the same time. This means that we can share our skills and knowledge with the family carers and patient, but with the benefit of the technology, we can give support sooner. What we all want is to provide the right care before a problem, which could be managed safely at home, becomes a real emergency” – the right care at the right time in the right place.
Ben Green, Consultant Respiratory Physician at the Queen Alexandra Hospital described the challenges he and his team face in caring for patients with severe respiratory disease:
“Numbers of patients with severe airways disease are chronically infected with bacterium PA and, despite attempts to treat these infections, complete eradication is difficult. Flare-ups of the infection are common, leading to a deterioration in symptoms leading to prolonged hospital admission. Hospital admission for this type of disease reduces quality of life and can be associated with increased mortality.
This work is important because it is helping to develop a tool for the early detection of flare-ups which will mean patients can be treated earlier at home, improving quality of life and reducing the costs to the NHS of hospital admission.”
Emergency admissions for COPD are the 2nd highest of any disease area in the UK, with 1 in 3 people with the disease being readmitted within 28 days.
Early intervention and better self-management at home could together, reduce the number and severity of admissions and increase life quality by slowing the rate at which the disease progresses.
Aseptika was attracted to work with Professor Chauhan because of their strong track record of research at PHT and its leadership in establishing self-care plans for patients with respiratory conditions to improve care in a sustainable healthcare model.
Dr. Kevin Auton, Founder and inventor commented:
“Whatever the cause, respiratory disease predisposes us to repeated lung infections, which damage the lungs irreparably, leading to more infections in a downward spiral.
While these diseases are complex, there are predictable patterns. The changes that can be seen in the lead-up to the next exacerbation can be measured with very simple devices that everyone can be taught how to use. If we learn from the information we gather about ourselves, we can adopt new behaviours and see how best to implement the self-care plans and the advice about medication, exercise, lifestyle and diet that our doctors give us.
With education, support and a bit of encouragement, we can slow the rate at which these diseases progress. All it takes is to make a few quick health measurements at home each day using our simple devices.
We have seen in previous clinical trials that the pattern of these complex changes can be easily identified. Eventually, we want to transfer this skill to the patient. In doing so, we want to help them reduce the number of their infections, decrease emergency hospital admissions and improve their quality of life and that of their carers.
We were very impressed with the initiatives for “hospital at home” that have been trialled by the clinical researchers in Portsmouth. We hope that our technology will enable their vision to be realised.”