Design and usability test of age-stratified afloPaediatric apps connected to the aflo asthma management device and platform

**Globally asthma is the most common non-communicable disease in children,** with about 10-15% having asthma symptoms in the last year. Inhaled medication is the mainstay of treatment but **inhaler technique errors amongst all users and all devices are highly prevalent**. Evidence shows **high asthma prevalence in children in the UK with 1.1 million children on active asthma treatment**. Being born into poor circumstances increases the risk of developing asthma by 70% (NIHR). The **UK has the worst death rate for asthma in children and young people aged between 10 and 24 in Europe (Asthma+LungUK)**_._ The **Life Sciences Vision Respiratory Mission priorities describe the global need 'to significantly reduce the number of attacks, hospitalisations and deaths_',_ to develop 'better monitoring technologies_'_ and for '_more effective treatment options for asthma, particularly children and young adults_'.**

Kennedy (2022) showed that **only 13% of children with asthma presenting at ED/ admitted had correct inhaler technique**. Poor adherence and **incorrect inhaler technique are significant drivers of poor symptom control** (McCrossan et al 2022).

NICE guidelines **(NG80) recommend inhaler technique should be trained and reviewed annually to optimise medication and improve symptom control**. This is **unachievable** in the current pathway for capacity and technology reasons.

Over the last 3 years, with the support of previous IUK awards **this project team has successfully co-designed, built, patented and clinically tested the functionality of a deep tech respiratory platform, aflo, for adult inhaler users**, to medical device standards. It was **co-designed with users to automate all steps of the UK Inhaler Group recommended inhaler technique**, to **improve outcomes, allow remote monitoring, reduce healthcare utilisation**.

Our trial data shows that a **paediatric specific platform is needed to optimise medication**. Post Covid capacity issues have resulted in limited access to in-person primary care support for inhaler technique training and patient review. The **primary goal of this research proposal is to address the well recognised challenge of establishing persistent correct inhaler technique for children with asthma**. Through this R&D we will **co-design with children, carers and clinicians, and test 3 personalised, age-stratified apps - afloPaediatrics - integrated with the latest sensor technology in the aflo device, delivering a data driven approach to inhaler technique training and clinical monitoring**. This will embed correct inhaler technique and **support a new data driven, hybrid asthma care pathway for children**, which supports the NHS Net Zero target, reducing high carbon Short Acting Beta Agonist over-reliance.