The clinical management of asthma hinges on the patient taking their medication, so that they can live a normal life, unimpeded by their asthma. Many young patients do not want to be different from their peers, and so try to manage without taking their inhalers, so TECS can help by giving them better information, and reminding them to take their inhalers or check their peak flow.

The Asthma management plan used locally in North Staffordshire is also in the resources section.

The Manage Your Health app, created by Keele University, the West Midlands Academic Health Science Network and Stoke-on-Trent CCG which is free to download, has useful information which patients can have on their smartphone.

One particular benefit of this app is the use of an avatar to demonstrate inhaler technique, including with a spacer. The app was developed with a focus group of children, so is suitable for most age groups. Below is a video in which Ann, a practice nurse, is reviewing a patient with asthma, showing her the Manage Your Health app. Included in the app is the Asthma Control Test, which patients can use to keep a check on their asthma.

Another app: ‘My Asthma’ produced by GlaxoSmithKline with Nottingham University also uses the Asthma Control Test to help patients manage their asthma better, and prevent asthma attacks.

Flo can also be used to remind children or their parents to use their inhaler, or for older children, can be used to control asthma and predict the likelihood of an asthma attack, using daily peak flow readings.

A clinician using Flo for daily peak Flow readings needs to choose the protocol with the nearest predicted peak flow to that of the patient. (Each protocol is 50 litres/min different from the next). This enables Flo to let the patient know when they are at 75% of their maximum, 60%, and so on, to help them relate to their management chart.

As you can see from the video below, Dr John Alexander speaks about the use of Flo in paediatrics.

When reviewing patients with asthma, video consultation using Skype or a similar alternative could give a doctor or nurse more information on which to make any decision about the actions a patient should take. For routine follow-up reviews, Skype may well offer options which would be preferable for hard to reach patients, who otherwise may not attend a review.

Using a closed Facebook group for peer support, overseen by a clinician could be helpful in some situations. A clear disclaimer would be used, to make sure that patients continue to follow the advice of their health professional. On the whole, experience has shown that patients do not wander into the realms of offering medical advice, but can give practical advice on alleviating the effects of climate or exercise to help manage a condition better. Health messages can be publicised on an open Facebook page, with You tube videos or animations capturing the interest of people who may not usually respond to posters or leaflets. Linking with other community Facebook pages can also increase the wider uptake of health messages that you want to publicise.

For asthma, apart from the Manage Your Health app, there is ‘ My Asthma’ app, which is also free. Produced by GlaxoSmithKline and Nottingham University it improves understanding of how asthma attacks occur, using the Asthma Control Test