A Pilot Study of the Effect of an Educational Web Application on Asthma Control and Medication Adherence

Clinical Impact of Electronic Monitoring Devices of Inhalers in Adults with Asthma or COPD: A Systematic Review and Meta-Analysis

“…We found eight observational studies [ 28 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] and 10 clinical trials meeting the criteria [ 23 , 27 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ] ( Figure 3 , Table 1 and Table 2 ).…”

“…No differences in SABA use were found in one study [ 61 ]. Studies assessing disease control with ACT or ACQ questionnaires showed mixed results: three studies found no differences [ 27 , 51 , 52 ], one study showed better results in the intervention group [ 62 ] and one study showed improvement for the previously uncontrolled subgroup only [ 23 ]. One study assessed independently additional symptoms (cough, breathlessness, nocturnal symptoms, wheeze, etc.).…”

“…The intervention group improved all the symptoms over the study period, but no direct comparison across groups was performed [ 58 ]. In relation to quality of life, four trials found no differences between groups [ 52 , 55 , 60 , 62 ] and one study found better results over time in the intervention group [ 58 ]. As for other variables, none found statistical significance: FeNO, PEF, exacerbations, time to exacerbations, steroids use, ED visits, hospitalizations, FEV1, technique error, critical technique error rate and composite clinical variable criteria [ 27 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ].…”

“…Other studies based their monitoring in Chronologs (Medtrac Technologies, Model MC-311, Lakewood, CO, USA); Diskus Adherence Logger (DAL, developed by a study researcher); INCATM (Inhaler Compliance AssessmentTM); MDILog ® (Life Link Monitoring, Inc, Kingston, NY, USA); Nebulizer Chronolog (Forefront Engineering Corp, Denver, Colo); POEMS (Pharmis GmbH, Beinwil am See, Switzerland); Smartinhaler (Adherium Ltd., Auckback, New Zealand); SmartTrack ® device (Nexus6, Auckland, New Zealand); and Respiro ® (Amiko Digital Health Limited, London, UK). Sensors were attached to pMDI in seven studies [ 23 , 28 , 44 , 47 , 50 , 61 , 62 ], to DPI in three studies [ 45 , 53 , 58 ], both to pMDI and DPI in four studies [ 48 , 51 , 52 , 55 ] and was not specified in four studies [ 27 , 46 , 49 , 60 ]. Data from EMDs lead to interactions with patients through smartphone applications in eight studies [ 23 , 27 , 28 , 44 , 48 , 49 , 51 , 55 ].…”

“…Some smartphone applications and additional means of interconnectivity allowed patients to provide, autonomously, data on variables such as ACT, symptoms, self-efficacy or QOL in several studies. Feedback and related actions from the monitoring sensor system were patient-oriented in five studies [ 44 , 45 , 47 , 48 , 49 ], healthcare professional-oriented in five studies [ 46 , 52 , 53 , 58 , 61 ] and comprised both patients and healthcare professionals in eight studies [ 23 , 27 , 28 , 50 , 51 , 55 , 60 , 62 ]. Patients received self-management interventions in 13 studies, with a varied range of actions: feedback of inhaler use, reminders, automated decision support system, gamified challenges, identification of potential triggers and guidelines-based education [ 23 , 27 , 28 , 44 , 45 , 47 , 48 , 49 , 51 , 52 , 53 , 55 , 60 ].…”