Title: Technology Enhanced integrAted asthMa care. TEAM-care
Funder: Department of Health and Social Care

Abstract: 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.

Lay abstract: Asthma is a common childhood illness, but care is not as effective as it should be which leads to poor health and problems for children and families. There are problems in healthcare for asthma and the way it is provided. This causes suffering for children and families, and can also cause lives to be lost. These problems also cost a lot for the health service and all of society since dealing with problems is more expensive and difficult than preventing them in the first place. We aim to improve health for children with asthma by testing a new type of more joined-up care that is about the whole child and not just the disease, and combining it with special apps for asthma. We think the new type of care is already helping children, but we could do even better by adding new ways of helping children and families to keep track of asthma symptoms and asthma medicines using apps. By combining the new type of care with apps, we want to help children and families and their doctors and nurses take better care of asthma together, to help keep asthma under control between visits to the doctor or nurse, and to improve asthma care so much that children can avoid needing to see a doctor for emergencies. We will test two types of asthma app together with joined-up care. The first one, called &quot;wheezo&quot; is for keeping track of wheeze symptoms. The second one, called &quot;propeller&quot; is for keeping track of asthma medicines and for providing advice and support. Both apps together could help children and families and their doctors and nurses to look after asthma better, so by testing each one separately we'll know whether each one works. If they work well, we can combine both apps together and use them in the new joined-up care for asthma so that children will have better quality of care. We would like to test the new way of providing care for children with asthma using the best test design - a trial, working closely with children, parents and carers to get it right. We will also test how things are going in day-to-day care, to help understand how things are going as early as possible and so we can improve things as we go. We will measure how often children need emergency care for asthma, their health, children and parents' mental health and wellbeing, how often children need healthcare and medicines for asthma, and whether children and their parents or carers miss school or work because of asthma, costs, and how easy the apps are to use. The evidence from our project should help improve health for children with asthma.

Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: RESPIRATORY