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Improving Inhaler Technique Using Real-time Identification of Device Errors with Smart Inhalers

Chrystyn H.

RDD Europe 2019. Volume 1, 2019: 85-96.

Abstract:

Smart inhalers with connective technology linking to a companion mobile phone app can provide dose reminders, feedback, and eHealth reports about a patient’s actual real-life dosing adherence and inhaler technique. Devices that only monitor dose preparation or inhaler actuation, with a date and time stamp, do not provide a realistic indication that the dose was actually inhaled by the patient and do not provide feedback about the inhaler technique. However, these devices can send reminders if doses are missed to improve adherence and disease control. Smart inhalers that also measure an inhalation flow profile, together with a date and time stamp, confirm a dose was prepared and inhaled and can also identify important aspects of the patient’s inhaler technique. A study in COPD patients revealed that only 28% patients had good adherence rates and inhaler technique over the 90 days following discharge from hospital. Furthermore, the study also revealed patients with poor adherence and poor inhaler technique were 3.4 more times likely to die than those with good adherence and good technique. Rescue medication usage can also be monitored by smart inhalers and when this suddenly increases, with or without deteriorating inhaler technique, could indicate a worsening of disease control and an impending acute exacerbation. Monitoring rescue medication usage would enable alerts to be sent so that early interventions can be made and exacerbations prevented. Standard counseling, relying on the patient’s reported adherence, and inhaler technique training in the clinic has failed. The use of smart inhalers giving feedback to the patient about their inhaler technique and eHealth reports of real-life inhaler usage used during counseling sessions could provide a much needed solution for improved disease control and reduced healthcare costs.