Congratulations on The Google Impact Challenge win. Can you explain what TEXTCARE does and what issue it addresses? 0:07 – 3:09
It is really exciting; I think we’re all a little bit stunned still, although I feel that we did have a fabulous proposal and it’s very exciting to think that we will have the opportunity now to implement it. So TEXTCARE is a way of approaching people with chronic disease that enables us to craft messages and help them manage their disease more appropriately across healthy lifestyle and medication use and keeping up with clinic appointments. So the whole spectrum of interaction between the clinician and the patient can change, using text messaging and the really positive thing about this, is that it’s not just a recipe where you just send a good piece of advice to a patient every day or every week, this is actually tailored to the patient. So we generate a whole range of healthy lifestyle and medication and treatment intervention messages, some of these are, for instance if you have heart disease they’re not only around taking your medications for your heart disease but also around monitoring your weight, doing your physical activity every day, being careful about your diet. But they’re tweaked to the individual patient. The patient chooses the message they want or the sorts of messages that are likely to appeal to them and then progressively the system is refined so the that patient is receiving more and more tailored messages that totally suit their needs, their lifestyle, the things they know they’ve said they’ll respond to and we all respond to different sorts of messages, things matter to some of us more than to others, some things we can squeeze into our day more than others and this system is an approach to tailoring to the individual, so that you’re all the time trying to encourage them to respond to positive messages about their health and about managing their chronic disease. And we’re going to do this in patients with COPD and asthma, it’s been shown to be effective in cardiovascular disease, it helps people to lose weight, it helps people to be more physically active, it helps them to take their medications and lower their blood pressure, it helps them stop smoking. Many of these things are things if people with asthma and COPD can do more effectively can really influence the course of their disease and achieve better outcomes. So, it’s a fantastic opportunity to test it in other diseases, we won’t only be doing it in lung disease and heart disease, we’re doing it diabetes, mental health, chronic kidney disease.
In which countries are you planning to roll out the respiratory component of TEXTCARE? 3:10 – 4:11
We haven’t yet got down to the nuts and bolts of where we’re going to do the studies. I would love to do one study in asthma and perhaps do that in Australia using text messaging and TEXTCARE for people who have troublesome asthma who are often not adherent with their medications but who could get real gains if they could improve their adherence. On the other hand, I’d like to use the COPD text messaging perhaps for an environment where we know people do use mobile messaging a lot, but where there is poor access to care, like China; I would love to a TEXTme study in China for instance or in some other Asian country similarly where there is difficult access to quality care and where you’ve got the potential for so much gain by using a simple digital interaction that’s suited to the patient.
TEXTCARE has a proven impact on cardiovascular disease and will be expanded to include COPD and asthma. Can you think of any more technologies that have enhanced your capacity to run a respiratory trial? 4:12 – 5:32
Yes, I think there are really two stand out technological advances in airways disease studies that have made a huge difference. The first is the insertion of an electronic chip into an inhaler so that we can actually measure the date and time the patient took the medication, the number of puffs they took, and also the inspiratory flow to check where they’re using the inhaler correctly. So that is one really stand out advance that enables us to measure adherence and to look at the study medication use; and the second is an electronic diary card. These electronic diary card, a card is quite the wrong word, it’s actually a little device in to which the patient blows and it measures their lung function and it also asks them questions about their symptom control. So they fill out a symptom control questionnaire, very simple to do, using digital technology and then they blow and you measure the lung function day by day; both those things have been fantastically valuable in getting more reliable metrics in clinical trials in asthma and COPD.