Digital Inhaler Data Can Potentially Identify Real-Life Issues With User Technique


Inhalation therapy is reliant upon correct inhaler technique to allow for optimal deposition of medication.

A new study has found that collecting inhalation parameters from a digital inhaler can potentially provide data to support patients and health care professionals in the identification of real-life issues with inhaler technique, according to a poster presented at the virtual 2020 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting and Exhibition.

Inhalation therapy is a crucial part of asthma management, delivering medication to the site of action. However, treatment is reliant upon correct inhaler technique to allow for optimal deposition of medication, according to the study authors.

Patients typically do not maintain correct technique at home and have many errors, despite correct inhaler technique demonstrations in clinical practice or during study visits, with the most common error in patients with asthma was found to be insufficient inspiratory effort. These common errors are rooted from a lack of reliable information about inhaler technique is a challenge when managing patients with asthma.

Teva’s ProAir Digihaler (albuterol 90mg/dose) is an electronic multi-dose dry powder inhaler (eMPDI) with an integrated module that can accurately record inhalation parameters, such as peak inhalation flow (PIF), inhalation volume, inhalation duration, and time to PIF, with a time stamp. With this information, the researchers wanted to analyze the Digihaler in patients with exacerbation-prone asthma to help describe inhaler technique issues with the data.

A total of 397 patients with poorly controlled asthma were observed in a 12-week multicenter, open-label study, using the ProAir Digihaler instead of other rescue medications. Each patient experienced more than 1 episode of exacerbations 12 months before screening, a moderate-dose ICS plus other asthma controllers, and stable asthma controller dosing for more than or equal to 3 months.

Of the 397 patients studied, 91.4% made 1 or more valid inhalation from the Digihaler. The mean age in years was 50.1, with 80.1% of the patients being female, 78.8% identifying as white, and 18.6% identifying as black or African American.

The total number of inhalation events was 53,374 and 754 inhalers were used. The mean PIF was 76.8 L/min with a mean time to PIF of 0.52 seconds. Meanwhile, the mean inhalation volume was 1.44L, with a mean inhalation duration of 1.53 seconds.

The results recorded 80% of the inhalation events with a PIF above L/min, indicating good or at least acceptable technique, even without feedback from the companion smartphone app.

The study authors concluded that further studies evaluating the Digihaler with the companion smartphone app would be useful to determine if information obtained could help to address inhalation errors. This could help provide objective inhaler use information to health care providers and patients.


Chrystyn H, Safioti G, Buck D, et al. Real-life inhaler technique in asthma patients using an electronic multi-dose dry powder inhaler. Poster presented at: 2020 ASHP Midyear Clinical Meeting and Exhibition; virtual: December 6-10, 2020.

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