In vitro evaluation of an asthma dosing device: The smart-inhaler

Burgess, Scott C.; Wilson, S.; Cooper, David M.; Sly, Peter D.; Devadason, Sunalene G.

doi:10.1016/j.rmed.2005.09.004

Cited by 53 publications

(41 citation statements)

References 16 publications

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“…Throughout the 12-month follow-up, adherence was monitored by Smartinhaler (Nexus6 Ltd, Auckland, New Zealand), a validated electronic device logging the date and time of each ICS actuation [13,19]. At each follow-up visit to the clinic, the data recorded by the Smartinhaler were uploaded by the primary investigator (who was not involved in the clinical care of these patients) who also checked proper recording function.…”

Section: Assessment Of Adherence To Ics and Follow-upmentioning

confidence: 99%

It’s the adherence, stupid (that determines asthma control in preschool children)!

et al. 2013

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Although guideline-based asthma care and adherence to inhaled corticosteroids are predictors of asthma control, the role of adherence in maintaining long-term asthma control is largely unknown. This study was designed to explore the relationship between adherence to inhaled corticosteroids and long-term asthma control in young children with asthma.In this observational study, 81 2-6-year-old asthmatic children, using inhaled corticosteroids, closely followed-up in a programme with extensive self-management training, were enrolled. Adherence was measured daily for 12 months using Smartinhaler (Nexus6 Ltd, Auckland, New Zealand) devices. Longterm asthma control was assessed by parents and physicians and included clinical assessment, an asthma control questionnaire and lung function measurement. We examined the association of adherence to asthma control, adjusting for seasonal influences and clinical characteristics.Median (interquartile range) adherence was 87% (70-94%), and 64 (79%) children had well-controlled asthma throughout follow-up. Adherence .80% was associated with better asthma control, and we found no important confounders of this association. Children with persistent mild symptoms had lower adherence rates (p50.028).Guideline-based asthma care was associated with good asthma control in most children. Adherence to inhaled corticosteroids was an independent strong predictor of long-term asthma control, with highest levels of asthma control found in children with adherence .80% of doses prescribed. @ERSpublications Adherence to inhaled corticosteroids strongly predicts long-term asthma control in young children

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Section: Assessment Of Adherence To Ics and Follow-upmentioning

confidence: 99%

It’s the adherence, stupid (that determines asthma control in preschool children)!

et al. 2013

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“…A further study conducted three separate tests of reliability and found Doser accuracy ranged from 94%-97% [24]. Accuracy of 100% was reported in a study using 6 devices over 30 days [35], but another study using 16 Dosers over 61 months found that 8% had mechanical faults such as an unreadable display, battery failure and error messages [36].…”

Section: Relevant Literaturementioning

confidence: 98%

“…The device consists of a plastic casing, with slightly different shapes available for different medication canisters [40]. The device maintains a similar shape to that of a normal MDI casing, with a larger size to allow room for the battery and electronics [35].…”

Section: Relevant Literaturementioning

confidence: 99%

Electronic Monitoring of Adherence to Inhaled Medication in Asthma

Howard¹,

Lang²,

Patel³

et al. 2014

CRMR

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Abstract:The main treatment of asthma is inhaled corticosteroids. However adherence to these medications in asthma is often poor, with low adherence associated with excessive health care costs and an increased risk of emergency room visits and mortality. Although various methods are used to indirectly assess adherence, all have significant limitations whether used in clinical or research practice. The recent development of electronic monitoring devices (EMDs) for use with inhalers presents an exciting opportunity to easily and accurately measure inhaler adherence. This article summarises the current devices available; for each device features and limitations are considered, followed by a review of both the current clinical literature and data on reliability and accuracy. An overall summary is also provided to aid comparison of capabilities between devices and future issues pertaining to the use of EMDs are discussed, including barriers to adoption, stakeholder involvement, novel methods of communicating adherence data, recording of data and cloud storage. Finally key areas that still require investigation are highlighted.

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“…66 Some devices also have audio and visual reminders and are available in the United States. Unfortunately, the add-on device is device-specific, and most models cannot differentiate between inhalation and actuation of the aerosol.…”

Section: Monitorsmentioning

confidence: 99%

Assessing New Technologies in Aerosol Medicine: Strengths and Limitations

Berlinski

2015

Respir Care

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Aerosols are the mainstay of treatment for pulmonary diseases such as asthma, cystic fibrosis, and COPD. In addition, aerosols are also being used for systemic drug delivery. Patients need devices that are safe, reliable, portable, and easy to use; have few steps in their operation; help them keep track of the remaining doses; are not expensive; and provide age-appropriate positive reinforcement and feedback. Computational fluid dynamics, human factor sciences, and quality by design are now applied to device development. Matching patient, drug, and device remains a challenge. Formulary restrictions, the current status of the industry-academia relationship, and the need to use multiple platforms hinder the process. Patients and families need to participate in the selection of a device that is appropriate for them. Practitioners need comparative data to help them choose the right device. New devices and drugs can be compared with the existing technology using in vitro and in vivo methods (lung imaging, pharmacokinetic and pharmacodynamics studies). Drug manufacturers need to be able to justify coverage of new products by third-party payers by showing a positive cost/benefit relationship. Finally, post-market surveillance is necessary for old drugs with new devices or for new drugs and devices to ensure patient safety.

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In vitro evaluation of an asthma dosing device: The smart-inhaler

Cited by 53 publications

References 16 publications

It’s the adherence, stupid (that determines asthma control in preschool children)!

It’s the adherence, stupid (that determines asthma control in preschool children)!

Electronic Monitoring of Adherence to Inhaled Medication in Asthma

Assessing New Technologies in Aerosol Medicine: Strengths and Limitations

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