EIT Digital’s Willem Jonker and Amiko’s Duilio Macchi discuss digital wellbeing and the ACT4Y initiative for asthma control.
Asthma is a disease which affects over 300 million people worldwide, a number that is set to rise to 400 million by 2025. Each year, millions of hospitalisations and emergency department visits occur, driving costs to over $50bn (~€44.5bn) in the USA and €70bn in Europe. And many, if not most, asthma-related exacerbations are preventable with proper treatment.
The ACT4Y (Asthma Control For You through smart inhalers and personalised review of medication use) initiative, which is supported by EIT Digital under its focus area on digital wellbeing, is a digital adherence programme that Amiko, Reply and UTwente are running in Italy, UK, France and Germany, in partnership with leading pharmacy chains. Here, patients are given devices that attach as add-ons to the inhalers they are already using which are used to track when the medication is used, along with a series of parameters that indicate inhaler technique and the quality of the inhalations.
Pharmacists are given a web application which receives data generated by the sensors and displays accurate and objective metrics for an improved understanding of inhaler use and misuse. They can leverage this information to provide digital medication use reviews to their patients, to improve medication adherence, inhaler technique, asthma control and prevent exacerbations of the disease.
EIT Digital describes digital wellbeing as ‘Slowing down the healthcare costs is the key driver for innovation in the health domain. The objective is to lower the demand for cure and long-time care and allowing the youth, the working professional and the elderly to maintain a good quality of life. The focus is to leverage sensor data to keep people healthy (through prevention and early detection) or help them cope with existing conditions. Both physical and mental wellbeing are considered. Solutions will need to have an emphasis on usability and user adoption while respecting data privacy.’
EIT Digital’s CEO. Willem Jonker, told SciTech Europa Quarterly: “Digital Wellbeing focuses on prevention rather than cure. Prevention is achieved through digital technology monitoring physical and mental conditions as well as lifestyle behaviour. Based on the analysis of the collected data using techniques from artificial intelligence, early detection and lifestyle behaviour change can be supported. EIT Digital supports innovation and education activities in the area of Digital Wellbeing through the development of new products and services, the creation of startups, and supporting the growth of scaleups. Education is supported through various courses and summer schools.”
Innovation activities such as ACT4Y are important for both industry and EIT Digital because adherence is crucial for successful and effective therapeutic treatments. Jonker said: “Solutions like ACT4Y improve not only the quality of life of asthma patients, but also make their therapy much more effective. EIT Digital invests in these activities since they improve people’s life and at the same time create new business and thus contributes to the economy.”
Moving forwards, digital wellbeing will continue to be one of EIT Digital’s five focus areas, and the organisation has a strong and growing portfolio of innovation activities, startups and scale-ups. Jonker concluded: “EIT Digital is continuing its growth in terms of locations, partners, activities, students, and impact. This year two new locations will be opened: Edinburgh and Braga.”
A lack of data
For Duilio Macchi, the CEO of Amiko, the main underlying issue behind why both patients and physicians are failing to prevent asthma-related exacerbations is a lack of data that could be used to meaningfully describe the link between patients’ outcomes and the way they follow and manage their treatments. Speaking to SciTech Europa Quarterly, he said: “To use US Surgeon General Professor Everett Koop’s words: “Drugs don’t work if patients don’t take them (correctly)”. In respiratory health this is even more evident, since drugs are delivered via a sophisticated device (the inhaler) that requires the patient to perform each inhalation following specific maneuvers. This lack of evidence and personalised information prevents physicians from gaining a deep understand of the efficacy of prescribed treatments and therefore leaves the patient in a limbo of uncertainty and behavioural errors.”
The first four inhaler add-on modules are already available for clinical trials and test beds in Italy, Germany, Portugal, and the Netherlands. Macchi also explained that “a second generation of devices are currently being developed, suitable for a wider adoption, ready to be used from early 2020. To foster the adoption further, we are partnering with the most prominent inhaler manufactures to directly integrate Respiro Sense into the delivery devices: the first example of this effort is the joint development with RPC Plastiape Group on their RS01.” This was recently announced at the Respiratory Drug Delivery Forum in Lisbon, Portugal (see: https://rs01x.com/).
When it comes to the new technology’s performance, Macchi highlighted that one of the most challenging hurdles was “embedding artificial intelligence into a tiny and off-the-shelf CPU with few computational capabilities and where energy usage was a central concern as the coin cell needed to last for more than one year. On the other hand, from the point of view of building a new model to positively engage patients and professionals, the most complex challenge is the inner complexity and variety of the healthcare system, with multiple layers of stakeholders’ interactions and a path to efficacy demonstration still not clear and KPIs still not properly defined.
“Despite the manifold faults and risks that all stakeholders need to overcome here, it is enlightening to see such strong support from such a prestigious European agency as EIT Digital,” he concluded.