National Evaluation of the Institute of Clinical Science and Technology Respiratory Toolkit

The state of asthma and COPD care in Wales has been identified as generally poor. This is manifested by late diagnoses, a failure to provide many aspects of basic care and a failure to collect adequate data. For example, data from the 2017/18 Wales primary care clinical audit showed that 75% of adults and 80% of children with asthma had no evidence of a personalised action plan in the previous year. Furthermore, only 49% of adults, and 35% of children had their inhaler techniques checked in the previous year (Royal College of Physicians, 2020). A followup audit in 2020 showed no improvement in these outcomes (Royal College of Physicians, 2021), suggesting a different approach was needed to change outcomes for people with asthma and COPD in Wales. Additionally, it is important to note that due to a lack of routine data collection, demonstrating the benefit of any intervention is also harder. The Respiratory Health Implementation Group (RHIG) aimed to use digital innovation to address some of the issues with respiratory care and reduce variation in practice across Wales. Since 2015, RHIG has worked with the Institute of Clinical Science and Technology (ICST) to develop and deliver digital solutions in a range of different areas, including asthma, chronic obstructive pulmonary disease (COPD), COVID-19 and tracheostomy care. The ICST toolkit was evaluated through a mixed methods approach. Quantitative and qualitative data from multiple sources were used to evaluate the toolkit’s impact on patient outcomes, behaviour change, and its effectiveness in helping people with asthma and COPD manage their conditions. Surveys were conducted with both patients and healthcare professionals (HCPs) to gather feedback on usability. Additionally, interviews with patients, HCPs, and commissioners were carried out to assess the broader value of the toolkit.