News Release

RCSI study shows digital device can improve patients’ asthma management

Peer-Reviewed Publication


Thursday, 6 April 2023: A new international study led by RCSI University of Medicine and Health Sciences has revealed significant potential for digital technology to improve asthma control for patients.

The study, published in The Lancet Respiratory Medicine, examined the effectiveness of combining information from digital device in a digital platform to effectively manage uncontrolled asthma. The findings, which on average led to a healthcare cost reduction of €3,000 per patient, demonstrate the future potential of digital medicine in the management of many chronic diseases.

Asthma is one of the most prevalent chronic respiratory conditions, affecting hundreds of millions of people worldwide. Steroid medicines can effectively treat and manage asthma, if delivered into the airways efficiently and in a timely manner using an inhaler.  About one in 10 people with asthma find they cannot control their asthma symptoms with inhalers, however, often experiencing severe attacks or needing stronger medication. It is thought that in some of these cases, patients may not be using the inhalers effectively.

To assess this, doctors typically have had to rely on patients’ own reports about their inhaler use and symptoms to adjust medications. Now, novel technologies developed by the INCA Research Team at RCSI can deliver and monitor asthma care in a completely digital manner.

The Inhaler Adherence in Severe Unstable Asthma (INCA-SUn) study, led by the INCA Research Team, involved more than 200 patients with severe or difficult-to-control asthma at 10 centres across Ireland, Northern Ireland and England. Half of participants (the ‘control’ group) were monitored using traditional methods while the remaining participants (the ‘active’ group) had their inhaler use monitored by a device called an INCA.

Co-developed by RCSI and Trinity College Dublin, the INCA device provides an objective assessment of how patients use their inhalers, by measuring acoustic or sound-wave signals from the inhaler. The data is provided to the patient’s healthcare provider through a digital clinical decision platform which advises the best treatment, which may include educating the patient on effective inhaler technique.

The study revealed that patients assigned to the ‘active’ group improved their medication adherence and were less likely to require corticosteroids, thus avoiding potential side effects. Fewer were switched to more expensive biologic medications, with a larger proportion of patients having their medication levels reduced while still controlling their symptoms effectively.  

INCA Lead Investigator Professor Richard Costello, described how the 32-week study showed that the INCA devices can help to differentiate between people who have severe asthma and those who have difficult-to-treat asthma, which is one of the challenging distinctions that respiratory physicians often need to make. 

“This means that the digital monitoring technology can help doctors decide with more confidence which patients would benefit from a step up to biologic drugs, as opposed to continuing high-dose inhaled corticosteroid therapy alone.

“In this trial, which we believe to be the first of its kind, we have brought a completely digital approach to medication management and we believe that this is a substantial step towards improving the outcomes and economic burden in patients with severe and difficult-to-control symptoms,” said Professor Costello, who is a Professor at RCSI Department of Medicine and a Consultant Physician at Beaumont Hospital. 

The INCA SUn (Inhaler Adherence in Severe Unstable Asthma) study was carried out though the RCSI Clinical Research Centre (RCSI-CRC) and was funded by the Health Research Board, Medical Research Council, INTEREG Europe and an investigator-initiated project grant from GlaxoSmithKline.

With the support of Enterprise Ireland, Professor Costello has created an RCSI spin-out company called Phyxiom, which is translating the learnings from INCA-SUn into an AI platform that aims to transform the clinical outcomes of patients with uncontrolled asthma.


About RCSI University of Medicine and Health Sciences

RCSI University of Medicine and Health Sciences is a world-leading university for Good Health and Well-being. Ranked in the world top 50 for its contribution to UN Sustainable Development Goal 3 in the Times Higher Education Impact Rankings 2022, it is exclusively focused on education and research to drive improvements in human health worldwide.

RCSI is an international not-for-profit university, headquartered in Dublin. It is among the top 250 universities worldwide in the World University Rankings (2023). RCSI has been awarded Athena Swan Bronze accreditation for positive gender practice in higher education.

Visit the RCSI MyHealth Expert Directory to find the details of our experts across a range of healthcare issues and concerns. Recognising their responsibility to share their knowledge and discoveries to empower people with information that leads them to better health, these clinicians and researchers are willing to engage with the media in their area of expertise.

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