AI Article Synopsis
- This study investigates the use of a 'smart' inhaler to monitor how well severe asthma patients stick to their treatment, specifically inhaled corticosteroids, and its effect on managing their asthma symptoms.
- After switching patients to a new inhaler, data such as blood eosinophils and asthma control scores were collected, showing that good adherence (over 80% usage) is related to better asthma outcomes.
- Results indicated that patients using the smart inhaler experienced significant improvements in asthma control without needing to start biological therapies, suggesting these devices could enhance treatment management.
Article Abstract
Introduction: One of the fundamental challenges of managing patients with severe asthma is treatment adherence, particularly with inhaled corticosteroids. Adherence is difficult to measure objectively and poor adherence is associated with worse outcomes. In this study, assess the ability of a 'smart' inhaler to record adherence in severe asthma patients and measure the impact of this on asthma control.
Methods: Consecutive consenting patients meeting criteria for biologics had their existing high-dose ICS/LABA//LAMA combination inhaler/s switched to mometasone/indacaterol/glycopyrronium (114/46/136). Routine clinical data, including blood eosinophils, FeNO, and ACQ-6 scores were collected at baseline and at 4 wk. Adherence was then checked on the Propeller Health app, and good adherence was defined as >80% of prescribed usage. Participants were then followed-up at 12 months to record the proportion of patients who were initiated on biologics.
Results: 77 patients (mean [SD] age = 50.4 [15.7] years, 67.5% female [ = 52]) participated. 71 participants were able to use the device and 65% ( = 46) of these attained good asthma control and were not initiated on biologics at 12-month follow-up. Both groups demonstrated a significant reduction in ACQ6 score at follow-up (2.81 vs. 1.92, < 0.001 and 3.05 vs. 2.60, < 0.001, respectively), but there was no statistically significant difference in improvement between groups. Patients with optimal adherence also demonstrated a significant reduction in median FeNO at follow-up (47 ppb vs. 40 ppb, = 0.003).
Conclusions: In severe asthma patients, 'smart' inhalers may represent an effective management tool to improve adherence and asthma control, therefore avoiding the need for patients to commence biological therapies.
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| http://dx.doi.org/10.1080/02770903.2024.2316726 | DOI Listing |
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