Assessing adherence to inhaled therapies in asthma and the emergence of
electronic monitoring devices
Abstract
Infrequent use of inhaled corticosteroids (ICS) and/or over-reliance of
short-acting beta agonists (SABA) are recognised as key contributors to
increased morbidity and mortality in asthma. The most frequent measures
of ICS adherence and SABA use relies on patient reported questionnaires
or prescription refill records, neither of which are considered
sufficiently reliable. Technological advancements in the development of
electronic monitoring of inhaler devices allow for monitoring of use, as
well as recording and feedback of inhaler technique for some devices.
Most electronic monitoring devices (EMDs) are paired with a smartphone
application, allowing patients to set reminders and display both
preventer and reliever use over time. This allows identification of
intentional and unintentional ICS non-adherence as well as frequency of
SABA use. This information assists clinicians in distinguishing
difficult-to-control from severe asthma. Although cost currently limits
widespread use, the introduction of EMDs into the asthma armoury is a
significant step-forward in asthma care and has the potential to improve
asthma related outcomes.