A qualitative process evaluation within a clinical trial that used healthcare technologies for children with asthma: insights and implications

Louisa Lawrie* (Corresponding Author), Steve Turner, Seonaidh Cotton, Jessica Wood, Heather Morgan

*Corresponding author for this work

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Healthcare technologies are becoming more commonplace, however clinical and patient perspectives regarding the use of technology in the management of childhood asthma have yet to be investigated. Within a clinical trial of asthma management in children, we conducted a qualitative process evaluation that provided insights into the experiences and perspectives of healthcare staff and families on (i) the use of smart inhalers to monitor medication adherence and (ii) the use of algorithm generated treatment recommendations.

We interviewed trial staff (n = 15) and families (n = 6) who were involved in the trial to gauge perspectives around the use of smart inhalers to monitor adherence and the algorithm to guide clinical decision making.

Staff and families indicated that there were technical issues associated with the smart inhalers. While staff suggested that the smart inhalers were good for monitoring adherence and enabling communication regarding medication use, parents and children indicated that smart inhaler use increased motivation to adhere to medication and provided the patient (child) with a sense of responsibility for the management of their asthma. Staff were open-minded about the use of the algorithm to guide treatment recommendations, but some were not familiar with its’ use in clinical care. There were some concerns expressed regarding treatment step-down decisions generated by the algorithm, and some staff highlighted the importance of using clinical judgement. Families perceived the algorithm to be a useful technology, but indicated that they felt comforted by the clinicians’ own judgements.

The use of technology and individual data within appointments was considered useful to both staff and families: closer monitoring and the educational impacts were especially highlighted. Utilising an algorithm was broadly acceptable, with caveats around clinicians using the recommendations as a guide only and wariness around extreme step-ups/downs considering contextual factors not taken into account.
Original languageEnglish
Article number0280086
Number of pages15
JournalPloS ONE
Issue number1
Publication statusPublished - 5 Jan 2023

Bibliographical note

Open Access via the PLOS Agreement
Funding: The study was supported by a grant awarded by the National Institute for Health Research (Efficacy and Mechanism Evaluation programme; reference 15–18–14). Circassia Ltd supplied 16 NIOX VERO® machines and associated consumables in support of the study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Data Availability Statement

All relevant data are within the manuscript and its Supporting Information files.


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