{
  "abstract": "Background Patients on an optimised asthma therapy regime who frequently exacerbate should be considered for biologic therapy. However, self-reporting of symptoms can be unreliable, and adherence to maintenance therapy can be difficult to confirm.Hypothesis Digital lung function and adherence monitoring can predict need for biologic therapy better than self-reporting of symptoms.Aim To review a national programme of digital adherence and peak flow monitoring in patients with difficult-to-treat asthma being considered for biologic therapy.Methods The first 150 patients with difficult-to-treat asthma referred to the national HSE Digital Living Lab programme were analysed. Patients were given digital adherence and peak flow meters. Adherence, peak expiratory flow (PEF), diurnal variability (DV) and exacerbation frequency were recorded over a 3-month period. A device-detected exacerbation was defined by a 20% reduction in PEF from baseline. Self-reported exacerbations were also recorded.Results A total of 117 participants (78%) engaged sufficiently with the digital monitoring programme. Outcome data were available for 72 participants (62%). Among these, 67 patients (74%) were considered for biologic therapy. Of those considered, 53 (79%) subsequently initiated therapy following the digital monitoring period. As summarised in table 1, baseline PEF, DV, exacerbation rate and blood eosinophil count were predictive of progression to biologic therapy.Abstract P303 Table 1Population demographics and factors predicting progression to biologic therapy. (All results presented as median [IQR]).Conclusion Factors identified by home digital monitoring were associated with a subsequent requirement for biologic therapy. Importantly, baseline lung function, diurnal variability and device-detected exacerbations may not be captured through traditional monitoring methods. Patients do not always perceive exacerbations, placing them at risk of under-treatment in the absence of digital monitoring. This programme underscores the value of digital health tools in enhancing referral pathways and informing decisions regarding biologic therapy in patients with difficult-to-treat asthma.",
  "authors": [
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "CM Gill"
    },
    {
      "affiliations": [
        "St James’ Hospital, Dublin, Ireland"
      ],
      "name": "LM Piggott"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "E Babikir"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "C Ottewill"
    },
    {
      "affiliations": [
        "St James’ Hospital, Dublin, Ireland"
      ],
      "name": "S Shelley"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "O Smith"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "H Doherty"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "E MacHale"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "G Greene"
    },
    {
      "affiliations": [
        "St James’ Hospital, Dublin, Ireland"
      ],
      "name": "BD Kent"
    },
    {
      "affiliations": [
        "RCSI University of Health Sciences, Dublin, Ireland"
      ],
      "name": "RW Costello"
    }
  ],
  "title": "P303 Real world assessment of impact of digital home monitoring in difficult-to-treat asthma",
  "uid": "dec7a61f-d813-51ad-b025-1e3c01913976"
}