Personalizing medicine - could the smart inhaler revolutionize treatment for COPD and asthma patients?

Greene, Garrett; Costello, Richard W.

doi:10.1080/17425247.2019.1628017

Cited by 22 publications

(18 citation statements)

References 19 publications

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“… 39 A personalized treatment approach aided with digital inhaler technologies is one such approach. 19 , 40 Technology-enabled inhalers offer a range of support such as patient reminders, feedback on inhaler technique and timing, and sensors to analyze inspiratory flow rates, and characterize inhaler technique. 19 , 40 Another novel technology-driven approach to improve adherence and patient behavior is by using a smartphone app.…”

Section: Discussionmentioning

confidence: 99%

“… 19 , 40 Technology-enabled inhalers offer a range of support such as patient reminders, feedback on inhaler technique and timing, and sensors to analyze inspiratory flow rates, and characterize inhaler technique. 19 , 40 Another novel technology-driven approach to improve adherence and patient behavior is by using a smartphone app. 41 The advantage with this approach is that it is constantly accessible, involves and educates the patient, and provides a repository for patient- and medication-specific information.…”

Section: Discussionmentioning

confidence: 99%

“…18 The development of personalized, data-driven approaches aided by new healthcare interventions is expected to play a major role in improving medication adherence in such patients through smart inhalers, electronic reminders and monitoring. 19 , 20 Recently, a connected inhaler system (comprising clip-on inhaler sensors, a patient-facing app, and a healthcare professional dashboard) was shown to improve adherence to maintenance therapy in patients with respiratory disease; however, such system did not show an improvement in clinical outcomes, possibly due to high adherence in the control arm. 21 This suggests the need for studies where the control arm is maintained as usual care.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Maximizing Adherence and Gaining New Information For Your Chronic Obstructive Pulmonary Disease (MAGNIFY COPD): Study Protocol for the Pragmatic, Cluster Randomized Trial Evaluating the Impact of Dual Bronchodilator with Add-On Sensor and Electronic Monitoring on Clinical Outcomes

Price¹,

Jones²,

Pfister³

et al. 2021

POR

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Background: Poor treatment adherence in COPD patients is associated with poor clinical outcomes and increased healthcare burden. Personalized approaches for adherence management, supported with technology-based interventions, may offer benefits to patients and providers but are currently unproven in terms of clinical outcomes as opposed to adherence outcomes. Methods: Maximizing Adherence and Gaining New Information For Your COPD (MAGNIFY COPD study), a pragmatic cluster randomized trial, aims to evaluate the impact of an adherence technology package (interventional package), comprising an adherence review, ongoing provision of a dual bronchodilator but with an add-on inhaler sensor device and a connected mobile application. This will compare time to treatment failure and other clinical outcomes in patients identified at high risk of exacerbations with historic poor treatment adherence as measured by prescription collection to mono/dual therapy over one year (1312 patients) versus usual care. Treatment failure is defined as the first occurrence of one of the following: (1) moderate/severe COPD exacerbation, (2) prescription of triple therapy (inhaled corticosteroid/long-acting β 2agonist/long-acting muscarinic antagonist [ICS/LABA/LAMA]), (3) prescription of additional chronic therapy for COPD, or (4) respiratory-related death. Adherence, moderate/severe exacerbations, respiratory-related healthcare resource utilization and costs, and intervention package acceptance rate will also be assessed. Eligible primary care practices (N=176) participating in the Optimum Patient Care Quality Improvement Program will be randomized (1:1) to either adherence support cluster arm (suitable patients already receiving or initiated Ultibro ® Breezhaler ® [indacaterol/glycopyrronium] will be offered interventional package) or the control cluster arm (suitable patients continue to receive usual clinical care). Patients will be identified and outcomes collected from anonymized electronic medical records within the Optimum Patient Care Research Database. On study completion, electronic medical record data will be reextracted to analyze outcomes in both study groups. Registration Number: ISRCTN10567920. Conclusion: MAGNIFY will explore patient benefits of technology-based interventions for electronic adherence monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Maximizing Adherence and Gaining New Information For Your Chronic Obstructive Pulmonary Disease (MAGNIFY COPD): Study Protocol for the Pragmatic, Cluster Randomized Trial Evaluating the Impact of Dual Bronchodilator with Add-On Sensor and Electronic Monitoring on Clinical Outcomes

Price¹,

Jones²,

Pfister³

et al. 2021

POR

View full text Add to dashboard Cite

show abstract

“…These so-called "smart inhalers" can make adherence assessment much more reliable, granular and objective. Smart inhalers come in various forms (see Figure 2), from simple tracking devices only counting the usage of an inhaler, to more sophisticated devices that provide reminders and personalized feedback to patients (106). Smart inhalers can provide objective and real-time data on inhaler use and can as such support adherence management either in combination with a self-management app (standalone option) or to facilitate consultations between patient and healthcare provider.…”

Section: Smart Inhalers: Objective Real-time Adherence Measurementmentioning

confidence: 99%

“…variability in adherence levels of participants can have a significant impact on the required samples size and trial power, and thus costs of the trial (106). Approximately 63% of the randomized controlled trials examining treatment for patients with severe asthma did not report whether the participants were adherent.…”

Section: Using Smart Inhalers To Detect Non-adherencementioning

confidence: 99%

Global burden of medication non-adherence in chronic obstructive pulmonary disease (COPD) and asthma: a narrative review of the clinical and economic case for smart inhalers

Jansen¹,

Hei²,

Dierick³

et al. 2021

J Thorac Dis

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Medication non-adherence to asthma and chronic obstructive pulmonary disease therapy poses a significant burden for patients and societies. Non-adherence encompasses poor initiation, implementation (including poor inhalation technique) and non-persistence. Globally, non-adherence is associated with poor clinical outcomes, reduced quality of life and high healthcare and societal costs. Costs are mainly caused by excess hospitalizations and impaired work productivity. Multiple intervention programs to increase adherence in patients with asthma and chronic obstructive pulmonary disease have been conducted. However, these intervention programs are generally not as effective as intended. Additionally, adherence outcomes are mostly examined with non-objective or non-granular measures (e.g., self-report, dose count, pharmacy records). Recently developed smart inhalers could be the key to objectively diagnose and manage non-adherence effectively in patients with asthma and chronic obstructive pulmonary disease. Smart inhalers register usage of the inhaler, record time and date, send reminders, give feedback about adherence and some are able to assess inhaler technique and predict exacerbations. Still, some limitations need to be overcome before smart inhalers can be incorporated in usual care. For example, their cost-effectiveness and budget impact need to be examined. It is likely that smart inhalers are particularly cost-effective in specific asthma and chronic obstructive pulmonary disease subgroups, including patients with asthma eligible for additional GINA-5 therapy (oral corticosteroids or biologics), patients with severe asthma in GINA-5, patients with asthma with shortacting beta2 agonists overuse, patients with asthma and chronic obstructive pulmonary disease with frequent exacerbations and patients with asthma and chronic obstructive pulmonary disease of working-age. While there is high potential and evidence is accumulating, a final push seems needed to cost-effectively integrate smart inhalers in the daily management of patients with asthma and chronic obstructive pulmonary disease.

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A Review of the Unique Drug Development Strategy of Indacaterol Acetate/Glycopyrronium Bromide/Mometasone Furoate: A First-in-Class, Once-Daily, Single-Inhaler, Fixed-Dose Combination Treatment for Asthma

et al. 2022

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A novel, once-daily (o.d.), fixed-dose combination (FDC) of indacaterol acetate (IND), glycopyrronium bromide (GLY), and mometasone furoate (MF), delivered by the inhaler Breezhaler Ò device, is the first long-acting beta2adrenergic agonist/long-acting muscarinic antagonist/inhaled corticosteroid (LABA/LAMA/ICS) therapy to be approved for maintenance treatment of asthma in adults inadequately controlled on LABA/ICS. The approval of IND/GLY/MF in the European Union (EU) also included an optional electronic sensor and smartphone (or other suitable device) application, making it the first ''digital companion'' that can be prescribed with an asthma medication. As a result, the European Medicines Agency included this approval as one of the ''outstanding contributions

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Personalizing medicine - could the smart inhaler revolutionize treatment for COPD and asthma patients?

Cited by 22 publications

References 19 publications

Maximizing Adherence and Gaining New Information For Your Chronic Obstructive Pulmonary Disease (MAGNIFY COPD): Study Protocol for the Pragmatic, Cluster Randomized Trial Evaluating the Impact of Dual Bronchodilator with Add-On Sensor and Electronic Monitoring on Clinical Outcomes

Maximizing Adherence and Gaining New Information For Your Chronic Obstructive Pulmonary Disease (MAGNIFY COPD): Study Protocol for the Pragmatic, Cluster Randomized Trial Evaluating the Impact of Dual Bronchodilator with Add-On Sensor and Electronic Monitoring on Clinical Outcomes

Global burden of medication non-adherence in chronic obstructive pulmonary disease (COPD) and asthma: a narrative review of the clinical and economic case for smart inhalers

A Review of the Unique Drug Development Strategy of Indacaterol Acetate/Glycopyrronium Bromide/Mometasone Furoate: A First-in-Class, Once-Daily, Single-Inhaler, Fixed-Dose Combination Treatment for Asthma

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