Digital Health Transforming Inhalers

AUGUST 25, 2015
Recent advances in technology are offering immense oppurtunities to transform the inhaler into a tool that tracks patients' use of asthma and chronic obstructive pulmonary disease (COPD) medications.

Adherium Limited, which is known for its Smartinhaler device, recently formed a partnership with AstraZeneca that entails a long-term supply agreement. Under this agreement, Adherium will provide innovative new devices and sensors specifically to AstraZeneca, which will then incorporate the technologies into its global patient support programs for COPD and asthma.1

Adherium managing director and CEO Garth Sutherland stated that “These agreements represent a major advance in the treatment and management of respiratory disease, and will make a fundamental difference to the quality of life for people with asthma and COPD.”1 The company also noted that “fewer than 50% of asthma patients adhere to their prescribed preventative medications.”1

Because medication adherence is a major problem in patients with asthma and COPD, a study published in Lancet Respiratory Medicine investigated whether the use of an inhaler with an audiovisual reminder function would lead to better adherence and asthma outcomes in school-aged children who present at emergency departments with asthma exacerbations.2,4

An earlier study published in the Journal of Allergy and Clinical Immunology found greater adherence to asthma medications among patients who were given a Smartinhaler. These patients were also less likely to experience a severe asthma exacerbation compared with those managed under regular care with or without adherence discussions with their provider.3,4

The Smartinhaler device allows patients to track the date and time of their medication use and transmit audio and visual reminders when they miss a dose. It also warns when patients' medication use indicates that their condition is becoming uncontrolled. The data collected are automatically transferred to a smartphone app, personal computer, or remote monitor, where it can be shared with the patient’s provider.1
 
With the Smartinhaler incorporated into AstraZeneca’s inhaler medications, there are strong odds that medication adherence in patients with asthma and COPD will improve. Adherium asserted that the Smartinhaler has been clinically proven to increase adherence by up to 59% in adults and 180% in children with asthma. Additionally, adults can reduce severe episodes by 60%.1

As Adherium chairman Dr. Doug Wilson stated, “By providing objective and accurate data on a patient’s medication usage, we can now for the first time develop treatment plans tailored to each patient, and in doing so, dramatically improve their quality of life.”1
 
The collaboration between Adherium and AstraZeneca puts innovative digital health into top-selling inhaler medications, allowing health care professionals and caregivers to receive real-time data on patient adherence. With this insight, physicians can improve or tailor treatment plans, but the role of pharmacies remains unclear. If pharmacies are involved in improving patient adherence to inhaler medications, what roles will pharmacists have?
 
Other companies are also investing in digitally upgrading how asthma and COPD are treated. Gecko Health Innovations, a Boston-based startup, is seeking to upgrade the inhaler with smart sensors that track usage, and another company called Propeller Health is creating a suite of software and smart sensors to track usage of inhalers and link the data between providers and patients.
 
Will pharmacists be dispensing these devices and counseling patients on their use, or will they continue to track adherence based on how many times inhaler medications are refilled? Many pharmacists currently offer counseling on proper inhaler use, but with the added technology, they may also need to be prepared to address these innovations.

This article was written in conjunction with Steven Khov, a 2016 PharmD Candidate at MCPHS University, Worcester Campus. He is currently on his APPE elective medical writing rotation under the guidance of Dr. Aungst. He is interested in the roles that mobile technology and mHealth have with patients and pharmacists.

Resources:
  1. Adherium & AstraZeneca Partner to Improve the Lives of Individuals with Respiratory Disease. Adherium Web site. http://adherium.com/adherium-astrazeneca-partners. Published July 23, 2015. Accessed August 14, 2015.
  1. Chan AHY, Stewart AW, Harrison J, et al. The effect of an electronic monitoring device with audiovisual reminder function on adherence to inhaled corticosteroids and school attendance in children with asthma: a randomized controlled trial. The Lancet Respiratory Medicine. 2015. 3(3): 210-219. doi:10.1016/S2213-2600(15)00008-9
  1. Foster JM, Usherwood RT, Smith L, et al. Inhaler reminders improve adherence with controller treatment in primary care patients with asthma. J Allergy and Clinical Immunology. 2014. 134(6): 1260-1268.e3. doi:10.1016/j.jaci.2014.05.041
  1. Moore C. Studies Confirm Adherium’s Smartinhaler Substantially Improves Medication Adherence And Health Outcomes. Lung Disease News Web site. http://lungdiseasenews.com/2015/07/24/adherium-astrazeneca-partner-bring-class-leading-inhaled-medications-respiratory-disease-patients. Published July 24, 2015. Accessed August 14, 2015.


Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an assistant professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, and you can find him on Twitter @TDAungst.
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