Propeller Health offers solutions, such as Bluetooth-connected inhaler sensors and patient apps, to help enhance compliance and treatment outcomes for respiratory patients, such as those with asthma or COPD. The system monitors how often patients take their medication and can send alerts to caregivers if the disease is considered poorly controlled. The app also provides education for patients on how best to use their inhaler and helps them to learn about their condition and how best to control it, based on personal data on how they use their own inhaler. The company recently announced $21.5 million in funding from a mix of pre-existing and new investors.
Medgadget had the opportunity to talk to David Van Sickle, Co-founder and CEO, about the Propeller concept and the next steps for the company.
Conn Hastings, Medgadget: Is patient compliance a huge issue for respiratory patients? How do the systems offered by Propeller Health help to enhance compliance?
David Van Sickle, Propeller Health: There are many medications for chronic respiratory disease that are effective at eliminating or reducing symptoms when well used. Most are inhaled anti-inflammatories that need to be taken daily. Unfortunately, rates of adherence to these medications remain very low across the US, with as few as one in four doses taken as prescribed.
We believe that digital companions like Propeller can help make regimens more simple, convenient and personal, increasing adherence by addressing several common factors limiting routine use. For example, many people forget to take the medications, particularly when feeling well. Medication reminders delivered via smartphones, text messages, or on the medication themselves through audiovisual reminders, can be very effective at encouraging routine use. Of course, it is just as important that we help people better understand how the medications work and why they are necessary. Digital interfaces that use data from daily life to educate and guide are well suited to helping build that awareness.
In randomized, controlled, clinical trials, people using Propeller use their daily medications about 55 percent more frequently compared to their peers who are being monitored but not receiving any of the feedback from the system.
Medgadget: Patient education is a key component of the Propeller system. What can patients learn about their disease and treatment? How does this help them to avoid disease exacerbations?
David Van Sickle: In many cases, people with asthma could be doing much better than they are, but they don’t realize that more could be done to eliminate or prevent their symptoms. An important part of what Propeller does is change expectations about what is possible, and to help patients and physicians identify the right approach to their care and treatment.
Another important goal of the Propeller experience is to help patients learn what triggers their personal symptoms. When Propeller observes a rescue inhaler event, we pull in data on the local environment, including temperature, humidity, air quality, airborne allergens, and more. We can use that information to identify what might be causing a specific person’s symptoms and provide personal tips and content about how to avoid those specific triggers. Because we learn a lot about the time and place that symptoms occur, we’re even able to use information from others in the community to help individuals do better. As an example, we recently published a peer-reviewed paper on how environmental data can be used to predict asthma risk, and we launched the first ever local asthma forecast, which shows users the risk of having asthma symptoms based on their current location. The Propeller system also provides educational information on the patient’s medications, such as technique training, and the importance of adherence and the management of symptoms. We aim to improve patient self-management, reduce their symptoms, help them obtain control of their disease and reduce exacerbations.
Medgadget: The concept involves integration of Bluetooth inhaler sensors with a patient app. Is there a requirement for different sensors on “preventer” inhalers, the ones used to provide long-term control of symptoms, and “acute” inhalers, taken to provide immediate relief when symptoms become intolerable?
David Van Sickle: There are dozens of inhaler devices used in the modern treatment of chronic respiratory disease. At any given moment, a person with asthma may have two or three different types, each delivering a particular medication or combination of medications.
They come in a variety of shapes and sizes. There are pressurized metered dose inhalers, dry powder inhalers, and soft mist inhalers, and each of those has different instructions for use and techniques to be learned.
We make devices to monitor the variety of inhaled medications required to manage and control chronic respiratory disease. These include add-on devices that connect existing, marketed medications to Propeller, as well as fully digital inhalers that have embedded electronics.
Propeller also works with medications that have been connected by others. Some pharma companies will develop connected inhalers on their own or with other partners, and we expect those will be connected to the Propeller platform. That gives patients and physicians the most choice across the range of medications. We don’t expect people will want to have different digital experiences for their preventer medications and their rescue medications. Or to have to change to a new system when they switch medications.
Our goal is to be the primary digital software system for respiratory medicine. We focus on the digital interfaces and experiences that create and support the clinical improvements that result from putting information about medication to work to strengthen self-management and care and treatment.
Medgadget: Using real-world evidence, such as evidence of outbreaks of viral disease in the locality, the system can also recommend that a doctor prescribe a different medication or change dosage to help limit the risk of disease exacerbation. Can you explain in simple terms how the system assembles and uses real world evidence to personalize treatment recommendations for a given patient?
David Van Sickle: We have accumulated a vast amount of evidence about the real world burden and management of chronic respiratory disease. With information from connected medication, and patient reported details, we are able to see when, where and among whom symptoms are occurring in real time across communities.
At an individual level, this information represents important vital signs for the level of impairment and risk. For example, in a given person we may be able to see that despite being adherent with their current level of inhaled corticosteroid, they continue to have symptoms requiring frequent rescue bronchodilator use. In that case we can consider causes such as whether they might have poor inhaler technique, may require a higher dose or an additional medication, have some untreated comorbidity, or may be exposed to something causing symptoms. And we can work from there, with the patient and through our physician tools to help guide them to a recommended solution.
In Louisville we’ve been building a community-driven approach to improving clinical and community management of respiratory disease for the past few years, with funding from the Robert Wood Johnson Foundation and a mix of public and private partners. One of our goals there has been to develop our understanding of temporal and spatial patterns of risk across a region and population and help those data find their way into public health priority-setting and decision-making. The goal is for the City of Louisville to use these data to inform initiatives such as emissions reduction, traffic curbing and greening initiatives to help improve the quality of life of local citizens with respiratory disease. We recently published findings from this program summarizing how environmental factors influence spatial patterns of asthma risk in the peer-reviewed journal Environmental Health Perspectives.
Medgadget: Congratulations on the latest round of funding. How will this allow Propeller to develop in the coming years?
David Van Sickle: The funds will be used to connect additional branded and generic medications to Propeller and to expand our operations outside the US in partnership with a number of pharmaceutical manufacturers and organizations. We’re adding to the team, too, particularly in areas such as clinical and medical affairs, and data science, and are developing deeper integrations into and connections with the information systems across health care. Next year we expect to add a number of exciting distribution channels to help us scalably enroll larger populations into Propeller.
Medgadget: Currently, Propeller provides digital healthcare systems for respiratory patients. Could such an approach also be applied to other disease states? Do you foresee digital solutions having a wide impact on healthcare in the coming years, across the spectrum of human disease?
David Van Sickle: Yes, we have learned a lot about how to recruit, enroll and onboard people into digital programs, and how to build digital programs that are effective companions to traditional pharmaceutical regimens. We believe this has relevance in adjacent therapeutic areas, but for the near term, Propeller is focused on respiratory.
Link: Propeller Health…