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    Evidence generation plan for HTE10063 Digital technologies to support asthma self-management

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    2 Evidence gaps

    This section describes the evidence gaps, why they need to be addressed and their relative importance for future committee decision making.

    The committee will not be able to make a positive recommendation without the essential evidence gaps (see section 2.1) being addressed. The company can strengthen the evidence base by addressing as many other evidence gaps (see section 2.2) as possible. This will help the committee to make a recommendation by ensuring it has a better understanding of the patient or healthcare system benefits of the technology.

    2.1 Essential evidence for future committee decision making

    Clinical outcomes

    Data in clinical outcomes related to the condition are important to help understand whether changes in management or self-management lead to meaningful improvements in asthma control. Current evidence on exacerbations, medication use and lung function is limited and mostly non-comparative, so it is difficult to assess the real clinical effect of the technologies. It would be useful to collect information on the impact of the technologies on quality of life, as this is an important component of the overall effectiveness of asthma care.

    Uptake and attrition rates

    Quantitative evidence on uptake and attrition is considerably lacking across technologies. This limits the understanding of how people engage with the technologies, specifically across people with different levels of asthma control. This data is essential for the economic modelling, which is sensitive to the technologies' use. Information on how much people engage and sustain engagement with the technologies is key for future assessments.

    Impact on condition management

    Qualitative evidence suggests that it is possible to improve symptom awareness and understanding of the condition, but the evidence is still limited. More research is essential to determine whether the technologies can help improve people's knowledge, self-management and appropriate use of their personalised asthma control regimens.

    Healthcare resource use

    Evidence on healthcare resource use is limited across technologies. Few studies reported outcomes such as GP consultations, specialist reviews, emergency department visits, hospital admissions or changes in service utilisation related to asthma control. More information on healthcare use is needed to help understand the potential system benefits and inform the economic modelling.

    2.2 Evidence that further supports committee decision making

    Generalisability to NHS practice

    A substantial level of evidence was generated outside of the NHS or lacked details about the clinical pathway, medications and baseline asthma severity. This limits the confidence in how these findings can be generalised to NHS practice and NICE recommended management of asthma. Studies that can collect data on how the technologies fit into UK practice would improve clarity in their applicability.

    Barriers and facilitators to using apps

    Existing qualitative evidence highlights the potential benefits and practical challenges, including reduced engagement over time, limited digital confidence and mixed user experience with the technologies. A clearer understanding of barriers and facilitators across different demographic and clinical groups would support more realistic implementation planning and reduce the uncertainty in their adoption.