Speaker's Highlight

• Don Sin University of British Columbia, St. Paul Hospital (Canada)
  Kenneth R. Chapman Toronto General Hospital Research Institute (Canada)
• Parameswaran Nair McMaster University (Canada)
  Carolyn Calfee UCSF (U.S.A.)
• Gregory P. Downey University of Colorado School of Medicine (U.S.A.)
  David A. Schwartz University of Colorado School of Medicine (U.S.A.)
• Neil Schluger Tuberculosis Control Branch, California Department of Public Health (U.S.A.)
  Nick Kim Critical Care & Sleep Medicine, University of California San Diego (U.S.A.)
• Nicola Hananiah Baylor College of Medicine (U.S.A.)
  Jae-Joon Yim Seoul National University College of Medicine (Republic of Korea)
• Koichiro Asano Tokai University School of Medicine (Japan)
  Diahn-Warng Perng Taipei Veterans General Hospital (Taiwan)
• Konstantinos Kostikas University of Ioannina (Greece)
  Karin Klooster University Medical Center Groningen (Kingdom of the Netherlands)

• Digital Health Tools for Asthma Self-Management

  Asthma care increasingly extends beyond the clinic. Between appointments, patients must recognize changing symptoms, use inhalers correctly, follow an action plan, avoid personal triggers, and decide when professional help is needed. Digital health tools can support these tasks by bringing education, reminders, monitoring, and communication into everyday routines.

  For respiratory clinicians, the value of technology lies in better-supported self-management rather than data collection alone. A well-designed app, connected inhaler, or telehealth service should help patients make safer decisions and give care teams information they can act on.

  This focus is especially relevant to the respiratory medicine community represented by APSR and KATRD. Health systems across the region differ in language, connectivity, clinical capacity, and access to specialists. Successful digital asthma care must therefore be practical, inclusive, and adaptable to local needs.

  A New Layer Of Asthma Care

  Self-management begins with a shared understanding of the condition. Patients need to know the difference between controller and reliever medicines, identify worsening symptoms, and understand the steps in their written asthma action plan. Digital platforms can reinforce these lessons through short videos, interactive education, translated content, and reminders timed around medication schedules.

  Mobile applications can also help patients record symptoms such as wheezing, cough, chest tightness, and nighttime awakening. When paired with peak expiratory flow readings, activity levels, or medication use, these records may reveal patterns that are difficult to recall during a brief consultation. The information remains most useful when it leads to a clear decision, such as reviewing technique or contacting a clinician.

  Tools That Support Daily Decisions

  Smart inhalers and add-on sensors can record when a device is used and, in some systems, provide feedback about technique. Medication reminders may help people who frequently miss controller doses, while dose counters and refill alerts can reduce interruptions in treatment. These technologies should complement education, because an alert cannot correct an inhalation technique problem unless the patient receives understandable guidance.

  Telemedicine and secure patient portals extend the care team beyond the hospital or clinic. A nurse or physician may review symptom questionnaires, discuss treatment response, and adjust a management plan without requiring every visit to be in person. Remote consultations can be particularly valuable for patients who live far from specialist services, although urgent breathing difficulty still requires immediate medical assessment rather than a delayed virtual appointment.

  Turning Data Into Clinical Action

  Continuous or frequent monitoring can create large volumes of information. The goal is not to ask patients to measure everything, every day. Instead, monitoring should be matched to a clinical purpose. For example, a short period of symptom tracking may help assess control after a treatment change, while intermittent peak flow monitoring may support an individualized action plan for selected patients.

  Clinicians also need agreed thresholds for reviewing digital data. A rise in reliever use, repeated nighttime symptoms, or a sustained fall in peak flow could trigger an alert for follow-up. Algorithms may assist with triage, but they should not replace clinical judgment. False alarms can cause anxiety and workload, while missed alerts may create a dangerous sense of reassurance.

  Digital tool	Patient benefit	Clinical opportunity	Important limitation
  Asthma self-management app	Symptom logs, education, reminders, action-plan access	Identifies trends for review	Engagement may decline over time
  Smart inhaler sensor	Tracks use and may support technique feedback	Helps discuss adherence and device habits	Adds cost and may not fit every inhaler
  Peak flow monitoring	Provides a personal measure of airway change	Supports selected action plans	Readings depend on effort and correct technique
  Telehealth consultation	Easier follow-up and faster communication	Extends specialist and nursing support	Cannot replace urgent physical assessment
  Wearable or connected device	Tracks activity, sleep, or respiratory patterns	May provide broader context	Signals can be nonspecific or incomplete
  Patient portal	Secure messaging, records, and refill requests	Improves continuity of care	Requires digital access and health literacy

  Choosing Technology With Care

  A digital intervention should be evaluated by the problem it is intended to solve. If poor adherence is the main concern, reminders and medication-use feedback may be relevant. If patients struggle to recognize exacerbations, an action-plan tool and symptom monitoring may be more appropriate. If access is the barrier, teleconsultation and asynchronous messaging may provide greater value than a sophisticated sensor.

  Usability is a clinical issue. Interfaces should use plain language, readable design, accessible instructions, and local languages where possible. Patients with limited digital literacy may need demonstrations from nurses, pharmacists, or community health workers. Tools should function reliably on common devices and use low-bandwidth options when connectivity is inconsistent.

  Protecting Trust And Equity

  Asthma monitoring can involve sensitive health information, including medication use, location, activity, and communication records. Patients should know what is collected, who can view it, how long it is stored, and whether it is shared with third parties. Consent must be understandable, and data security should be treated as part of patient safety.

  Equity also requires attention to device cost, internet access, disability, age, and language. A digital pathway should never become the only route to care. Offering paper action plans, telephone contact, in-person education, or community-based support can prevent technology from widening existing gaps.

  Recommendations For Clinical Practice

  Implementation works best when patients and healthcare professionals test the tool together. A clinician can confirm that the action plan is medically appropriate, demonstrate inhaler use, explain alert thresholds, and establish what happens after a concerning entry. This creates a connection between self-recorded information and a defined care pathway.

  Evaluation should include outcomes that matter to patients and services: symptom control, exacerbations, oral corticosteroid use, emergency visits, adherence, quality of life, and patient confidence. Engagement metrics such as log-ins or completed questionnaires are useful, but they should not be mistaken for improved asthma outcomes.

  • Match each digital feature to a specific self-management or care-coordination need.
  • Combine reminders with inhaler education and regular technique checks.
  • Establish clear escalation rules for symptoms, peak flow changes, and frequent reliever use.
  • Protect privacy through transparent consent, secure systems, and limited data collection.
  • Provide non-digital alternatives so every patient can access an effective asthma action plan.

  Digital health can strengthen the partnership between patients and respiratory teams when it is clinically focused, easy to use, and supported by human contact. Congress discussions, workshops, and collaborative research can help identify which tools deliver meaningful benefits across different healthcare settings. By sharing evidence and implementation experience, the APSR and KATRD communities can shape safer, more equitable approaches to connected asthma care.

  Richard Russell Nuffield Department of Clinical Medicine, University of Oxford (United Kingdom)
• Mona Bafadhel King’s College London (United Kingdom)
  David Jackson Guy’s and St Thomas’ Hospital, King’s College London (United Kingdom)
• James Chalmers University of Dundee (United Kingdom)
  David Price University of Aberdeen (United Kingdom)