A Clinical Perspective on the Role of Electronic Devices in Monitoring and Promoting Adherence in Airways Disease

Abstract

Poor adherence to treatment is a common reason why patients with chronic disease have worse outcomes than might be expected. Poor treatment adherence is of particular concern among people with airways disease because, apart from not taking treatment as prescribed, inhaled medication can also be administered incorrectly. Recently, a number of technological advances that accurately document when an inhaled treatment has been used and, in certain instances, how it was used have been developed. There is good evidence from a number of research groups that these devices, either by patient reminders or physician feedback, promote adherence to inhaled treatments. What is less certain is how, in a real-world setting, these devices change outcomes. In this perspective article, the role of electronic devices in quantifying treatment use and addressing poor treatment adherence and their potential role in clinical practice outside of clinical validation trials are described.

Key Features of Smart Medication Adherence Products: Updated Scoping Review

“…For instance, the FindAir inhaler was able to capture pollutant levels in the surrounding environment at the location of use [ 96 ]. Similarly, Propeller was able to capture the location of use, and BETACONNECT autoinjectors could capture the depth of the injection [ 92 , 93 , 105 ]. Some products had the ability to capture one or more types of biometric data, such as blood pressure, blood glucose, heart rate, respiratory rate, and weight (eg, Pillgo, Respiro device, and Smart Pillbox Medicine Management System) [ 60 , 92 - 94 , 100 , 101 , 136 ].…”

“…In total, 32% (26/80) of the SMAPs provided data security assurance for mobile apps and web-based portal access via secure log-ins (ie, personal identification number or facial recognition). For products that did not have application installations or portals in the initial setup, medication adherence reports were sent to registered email addresses (eg, Wisepill) [ 11 , 51 , 54 , 76 , 92 , 93 , 105 , 130 , 137 , 140 - 148 ]. Currently, only 6% (5/80) of the SMAPs automatically integrate adherence data into other clinical platforms such as pharmacy software or electronic medical records.…”

Home monitoring in asthma: towards digital twins

“…The state of the art of the effect of electronic monitoring devices on asthma outcomes has recently been reviewed [13 ▪ ,14]. The first devices only provided data on patient adherence to their controller treatment.…”