Upgrading the Inhaler for Increased Adherence

FEBRUARY 17, 2015
Many companies are looking to reevaluate how to integrate new technologies into medical products currently on the market. In a previous article, I highlighted 1 company's endeavors in updating the EpiPen with new technologies to alert caregivers when a patient uses the device. This time, I want to highlight what is being done with inhalers.

The majority of pharmacotherapy related to asthma and other pulmonary diseases is reliant on delivery of medications to the lungs directly through multiple inhaled devices, such metered dose inhalers (MDIs), dry-powder inhalers (DPIs), and twist inhalers. Considering that adherence to therapy is tantamount to minimizing disease exacerbation, it is important to ensure that patients do not skip doses.
 
Gecko Health Innovations is a start-up company based in Cambridge, Massachusetts, that is looking to improve adherence to inhalers. The company's innovation is essentially a proprietary sensor called the CareTRx Sensor that can be attached to the canister of most MDIs.

The CareTRx Sensor will sync with a mobile app on a patient's smartphone to track adherence, which can then be uploaded to a computer dashboard for providers to follow. The sensor will light up when the patient is due for treatment and trigger an alert through the app when the device is in use.
 
The hope behind Gecko Health’s product is that it will foster increased adherence for patients with chronic pulmonary diseases that use inhalers on a daily basis. The product benefits from increased use of smartphone technology by most patients, and the ability to share such data with providers. The logic behind giving pulmonary clinics and providers another tool to help assess nonadherent patients or those overusing rescue inhalers makes sense, but there are several limitations to the CareTRx design that need to be mentioned.
 
For pharmacists, the most obvious concern and criticism is how this will work with all of the other inhalers on the market. For many, there are large changes afoot, including the transition of many inhalers to the respimat format (e.g. Combivent, Spiriva), which Gecko Health’s product does not seem to address.

Most chronic inhalers are not in an MDI format, which is a great limitation. Start-ups and other companies looking to integrate mobile technology into current medical products will need to develop products that can accommodate multiple functions and adjust for future drug developments. Otherwise, they risk becoming outdated as soon as they are implemented.
 
Mobile health holds a lot of promise, and the work that Gecko Health is putting into pulmonary disease is a sign of interest from the tech industry in disrupting current thought on the approach towards adherence with inhalers. Future designs will benefit from encompassing more inhalers and providing further feedback to users on their technique to maximize adherence and efficacy.


Timothy Aungst, PharmD
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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