Digital monitoring of inhaler use is associated with reduced short-acting beta-agonist use in airways disease (ID 498)
London North West University Healthcare NHS Trust, London, UK
Abstract
Aim: Digital inhaler dose counters can be used by patients and clinicians to monitor inhaler use in airways disease. It is unclear whether this leads to changes in inhaler usage. We aimed to assess whether the use of a digital dose counter leads to a reduction of short-acting beta-agonist (SABA) use in asthma and COPD.
Methods: The digital dose counter is connected to the patient’s metered dose inhaler. Recordings of inhaler actuation are automatically uploaded to a smartphone application. A survey was sent to all users of the digital dose counter to evaluate demographics and disease severity. SABA use was analysed for patients with asthma or COPD, and with at least 14 days of active use of the digital dose counter. Inhaled corticosteroid (ICS) use was also monitored in patients using ICS as maintenance treatment only.
Results: 130 survey responses were received. The average age was 54.6 ± 15.6 years and respondents reported 2.9 ± 4.0 exacerbations of their airways disease in the last year. In a 75-day monitoring period, the average number of SABA puffs per day fell from 2.7 to 1.4 (r = -0.56; P = 0.01) (Figure 1). The average number of active users of the SABA dose counter fell from 169 to 45. ICS use was highly variable, with users inhaling more than 4 puffs of ICS per day on 18.6% of the monitoring period.
Conclusions: Use of a digital inhaler dose counter was associated with a reduction of SABA use in a 90-day monitoring period, albeit with a reduction in the number of active users of the inhaler counter. ICS is variable, even if prescribed as a maintenance inhaler, and overuse is an important issue in airways disease. Research is needed into why use of digital inhaler dose counters falls over an extended monitoring period.
Funding: None
Conflicts of interest: Serena Alpi and Thomas Antalffy are employees of Smart Respiratory, which manufactures the digital dose counters mentioned in this study. Sachin Ananth is not affiliated with Smart Respiratory, and performed the final analysis and wrote the abstract.
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