How to alleviate life-limiting respiratory problems has taxed scientists’ brains since ancient times. The history of the issue is illustrated by sketches of sick people inhaling henbane fumes from hot bricks, adorning Egyptian tombs. Mass manufacturing during the Industrial Revolution – as well as the many associated respiratory diseases – sparked large-scale innovations to improve breathing. But the greatest leap forward, in the late 1950s – paradoxically around the time when doctors were commonly endorsing cigarettes – was the revolutionary metered dose inhaler (MDI), with its powerful aerosol technology, borrowed from hair sprays. Later in the 1990s, Proventil® HFA (in the U.S.) was brought to market by 3M.
Luckily, we’re on the cusp of a revolution – connected respiratory health. The ubiquitous smart phone, with all its powerful connectivity to apps, wearables, trackers and monitoring devices, is leading the charge. And a new field of digital respiratory medicine is already revealing the enormous possibilities of leveraging big data to improve the health of individuals as well as communities.
One amazed patient who grew up asthmatic in the 1950s shared with 3M a story she wrote to her father about the exciting new technology, “Remember how you taught me to puff-puff, and tap tap tapped on my back? Well it’s too late for me, but just think of the little kids who can have an easier life with this great new [stuff].”
Given the pace of change, she might even have expected that asthma, the world’s most common respiratory disease, would have been cured by now. But we’re not there yet. Not even close. 358 million people (PDF, 12.18 MB) are still affected by asthma, according to 2015 figures.
Thanks to great advances in inhalation medications over the last few decades, however, asthma has become a significantly less dangerous disease. Statistics (PDF, 12.18 MB) show that mortality rates (age-standardized) from asthma attacks have fallen by nearly 60 percent since 1990. Quality of life has also increased significantly for people with less severe asthma. Celebrities like David Beckham, singers like Pink and life-loving asthmatic roller derby girls Team Wheezy, show just how possible it is to enjoy full, extremely active lives while proactively managing their condition.
But there are still many people with severe asthma for whom the medications don’t always work so well. And, according to 3M respiratory health scientist, Steve Stein, there’s still a vast amount in addition to improving medications that should be done to improve the situation of asthma sufferers. “Although there’s currently no way to cure asthma, it’s about doing everything we can to keep the disease from progressing,” he says. “It’s always in the back of an asthmatic child’s mind that something can go wrong, and they can have an attack. How could we reduce that risk even further, so they and their families can get on with enjoying life?”
It’s in this risk-reduction that connected respiratory health can make a big difference.
By unleashing the power of real-time data, new connected solutions help patients with the most fundamental problems they face:
Stories from the field help explain the power that modern digital data brings to trigger identification. David Van Sickle, CEO of digital therapeutics company Propeller Health, describes how, as a CDC “disease detective,” he learned about a mysterious asthma outbreak in Barcelona in the 1980s. Emergency rooms in Barcelona saw numerous dramatic outbreaks of emergency room visits for asthma between 1981 and 1987. More than 1,100 people ended up hospitalized and, tragically, 20 died. It took experts eight long years to identify the culprit: massive clouds of soybean dust near the waterfront caused by a lack of proper filters on harbor silos. Until this point, soybean dust had never been identified as an allergen.
“I saw that if we could somehow passively monitor medication usage and symptoms, tragedies like these could be avoided, new clues about the causes of asthma uncovered much faster, and patients helped to stay away from dangerous triggers,” explains Van Sickle.
Computer science and the power to mine and correlate vast amounts of health and environmental data is driving a new kind of “digital epidemiology,” or understanding of disease outbreaks at scale. But it’s the impact on individual lives that resonates most.
Intelligent inhalers, expected to be on the market by the end of the decade, could help patients in many ways.
First, they could help drive consistent inhalation of medication. By leveraging innovative respiratory science and connected technologies, devices could, for example, help control the inspiratory flow rate, so that variations in breath power do not affect dosages.
Second, they could help people manage their inhalers better by incorporating step-by-step, on-screen instructions and prompts.
And third, by pairing with mobile apps, they could provide real-time data for patients and doctors about device usage, as well as long-term trends in breath profiles.
Steve Wick, technical director at 3M, explains that intelligent inhalers could also make it easier for doctors to objectively assess how well a treatment is working so they can change the plan as quickly as possible if needed.
The future looks very positive. Van Sickle echoes the words of many other connected health advocates when he explains, “We’re changing the way people experience chronic respiratory disease and finally starting to close long-standing gaps in what should have been achieved with medications we already have available.”
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