Anaphylaxis – could an app save your life?

Interviewer: Sam Walter (Interviewer, Ideas Lab)
Guest: Dr Sandra Woolley
Recorded: 03/06/2014
Broadcast: 28/07/2014

Intro VO: Welcome to the Ideas Lab Predictor Podcast from the University of Birmingham. In each edition we hear from an expert in a different field, who gives us insider information on key trends, upcoming events, and what they think the near future holds.

Sam: We’re here today with Dr Sandra Woolley in the School of Electronic, Electrical and Computer Engineering, here at the University of Birmingham.  Hello Sandra. 

Sandra: Hi.

Sam: So can you tell us a little bit about what you do here at the university?

Sandra: Well, my area of research is pervasive health and we work on technologies using mobile phones, wearable and ambient sensors, to collect information relevant to health. 

Sam: So this is sort of a response to the rise of assistive and health technologies over the last few years.  Who’s been the biggest benefit of these health technologies do you think?

Sandra: I think there’s a long way to go yet. The area of assistive technology is relatively new at the moment. We’re all getting used to having things like mobile phones in our lives and there’s lots of apps that we can download now, many of them very useful and lots of them related to health, but the area of health technology in general is still fairly new and we have quite a long way to go. So when you have an appointment and you go to see the doctor, if you get a prescription then it’s usually to go to the chemist and you’ll be given some medicine to take. You don’t usually get a prescription for something with batteries in, but if you look in the chemists now you’ll probably see that maybe there’s a whole aisle of things like blood pressure monitors, digital thermometers, all manner of health products that you can buy for yourself. So that’s wonderful, there’s lots of commercial changes and improvements in electronic health products but getting these into clinical practice is something that we still have some work to do on. So the area of assistive technology attempts to create useful technologies. There's a lot of interest at the moment in people with dementia and producing technologies to help them with their activities of everyday living. So for example, simple technologies to switch off the gas if they should leave it on, or to help them make telephone calls – nice big screens and pictures of the people that they want to call. So they just need to press the picture of the person they want to speak to and the phone will do the dialling for them. So there’s lots of examples of new assistive technologies but you’re more likely to read about these in the press, in magazines or if you go to a museum you might find that they’ve got a display there that shows you all the examples and you’re less likely to actually find them at the moment in people’s homes and I think in the next few years that’s what we’ll start to see.  We’ll start to see that happening for that technology to become a part of our lives. 

Sam: Fantastic.  And you’re involved in your own health technology aren’t you with the anaphylactic app. Can you tell us a little bit about that and what that involves?

Sandra: Yes. Well, anaphylactic allergies are those really serious allergic reactions. Most people have heard of it these days. Most commonly anaphylactic allergies are for peanuts, so the idea of being careful about peanuts is something that a lot of people have got used to, but you can be anaphylactic to other things. You can be anaphylactic to milk, you can be anaphylactic to egg, to fish – especially shellfish – and to bee stings, wasp stings and so on.  I think it’s around 2% of all children now that have anaphylactic allergies, so we’re looking at a problem into the future.  A lot of people living with anaphylaxis are having to be very careful.  It’s not just eating one or two peanuts that might be a problem, or the anaphylactic allergen, but it’s just simply maybe touching these allergens that can create very very nasty reactions and they can happen very very quickly.  I’m interested in this area because my son is anaphylactic. He’s anaphylactic to egg and we’ve had to be profoundly careful. So he wasn’t able to touch egg and he would have a very big and extreme reactions if he came across that. So we’ve been working on an app to help people learn how to manage their anaphylactic allergies. So if you have anaphylaxis you’re prescribed adrenalin in the form of an injector, an auto-injector. It’s really quite simple to administer but people can have a lot of problems with it. So you have an auto-injector filled ready and you just need to swing it and press it into your leg and hold it steady for ten seconds and then massage the area afterwards.  What we find though is that people tend to be not very good at giving an injection. Perhaps they don’t have the injector with them, but if they do have one or two injectors they may inject correctly, they may fail to use it properly, they may use it upside down – that’s one of the mistakes that can happen – instead of injecting their leg they inject their thumb.   So we’ve made an app that helps people learn how to use their auto-injector. Actually I should be careful, of course they will be properly trained by clinicians.  This will help them remember, I should say, how to use their auto-injector so that they can have a system of continuous practice and that they can help show their family relatives, or their school mates, their friends, whoever it is that might need to help them if they have a serious reaction and the system will score their performance and so they can keep practicing until they get a perfect score and the system could then remind them, at intervals, to practice again. It’ll also remind them to make sure that their auto-injectors are in date and check that they understand the procedure. 

Sam: Fantastic. It sounds like a really important piece of tech. So is the purpose of the app, just to make clear, it’s for training and it’s not to be used after someone has an anaphylactic shock, it’s to be used beforehand?

Sandra: Yes. It’s so that people will be prepared. The idea of – it’s called self-efficacy – this idea that if you believe that you can do a thing then you’re likely to do a thing. Was it Henry Ford who said ‘if you believe you can do it or if you believe you can’t, either way you’re right’. Self-efficacy is what he was talking about and it’s been demonstrated that if you do believe that you can do something, if you’re confident that you can do something, then you’re more likely to be successful and so what we’re hoping is that that will be true for anaphylaxis as it’s true for other things and so we’re improving people’s self-efficacy.  So we’re doing some experiments at the moment and we’re testing to see how well people are injecting, using our technology, and we’re also asking them questions about their self-efficacy. I should say that we’re working with clinicians on this project so that they have checked the training, they have provided the training and they’re working closely with us on the results that we’re producing. So it’s really important that we’re working on a prototype. This sort of technology isn’t something that should be released without careful testing and perhaps that’s something that distinguishes what we’re doing from a lot of the apps that are available freely online. But with anaphylaxis being something that’s life-threatening, it’s really important that we get it right and so we do a lot of testing and we do a lot of work with clinicians. 

Sam: Fantastic.  So that sounds like an incredibly important app to develop. Is this at a stage where people can download it or when will it be at a stage when people can use and download it?

Sandra: That’s a really good question!  We’re working on a prototype at the moment and we have the backing of the Anaphylaxis Campaign supporting our study. We hope to be publishing perhaps early next year on this and we hope that working with a number of hospitals, as we are with this study, and promoting this work amongst other clinicians that there will be much more interest in the area.  So the answer is I’m afraid that it’s not something that’s commercially available. There are some simple apps produced by the auto-injector manufacturers that are really useful. They will remind people of the steps of how to use the auto-injector, so rather than relying on the piece of paper that comes with the auto-injector you could have those on your phone.  That’s really lovely. What that technology can’t do though is give you feedback on your injection. But I would like to think that perhaps in a couple of years something like the technology that we’ve got, so we’ve got a sensor on the auto-injector that tells the phone about how the injection has been done. It would be great if something like that could be commercially available, perhaps in a couple of years. 

Sam: Fantastic. Well all the best of luck for the project and Dr Sandra Woolley, thank you very much for joining us today.

Sandra: Thank you very much.

Outro VO:This podcast and others in the series are available on the Ideas Lab website: There's also information on the free support Ideas Lab has to offer to TV and radio producers, new media producers and journalists. The interviewer and producer for the Ideas Lab Predictor Podcast was Sam Walter.