Smart Inhalers Lead to Decreased Usage, Fewer Symptoms in Asthma, COPD Patients

A new study suggests the technology can lead to dramatically better clinical outcomes.

A new study has found that “smart inhalers” can have a major effect on individual health and lay the groundwork for community-level improvements for asthma patients.

Researchers tracked the effectiveness of a small device that can be attached to a rescue inhaler to automatically record information about when and where patients use their medication. Those usage data can then be cross-referenced with environmental data to help patients better understand the situations that seem to exacerbate their condition.

The study details how a citywide collaboration in Louisville, Kentucky, affected residents with asthma. After 12 months, the overall patient group saw a 78% reduction in rescue inhaler use, and a 48% increase in symptom-free days.

Meredith Barrett, PhD, vice president of research at Propeller Health, the makers of the smart device, told Healthcare Analytics News™ that the sensor provides a level of accuracy in usage data that wasn’t possible before the digital health revolution. Previously, user-reported data were kept in paper or web-based diaries.

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“There have been a number of studies demonstrating there are issues with self-reported data, such as missing data (due to forgetting or just busy lives), fabrication, and not remembering correctly,” said Barrett, the study’s lead author.

Barrett cited one particular study, from 2008, in which more than 4 of 5 patients with poorly controlled asthma incorrectly characterized their asthma as “well-controlled” or “very well-controlled.”

The sensors eliminate the subjectivity of user-reported data, replacing those sets with scientific measurements. Barrett said more than 1100 patients participated in the Louisville program, dubbed AIR Louisville, for the entire year. She said users without much experience using technology received training to ensure they knew how to install and use the device and its corresponding smartphone app.

“That said, a large majority of the participants enrolled were shipped a sensor kit via mail, and they were able to set it up independently,” she said. “Human or technology error can still occur, so AIR Louisville had 2 respiratory therapists on the ground in Louisville to help participants with any technical or clinical questions. Additionally, Propeller runs a support phone line and website to help assist with any technical issues.”

The AIR Louisville program was a collaboration between the city, Propeller Health, and nonprofit agencies. The Robert Wood Johnson Foundation funded the study, with additional money from the American Lung Association.

In addition to the improved health outcomes for individuals, the study led to a number of recommendations for the city, which had been named one of the 20 “most challenging cities” for people with asthma by the Asthma and Allergy Foundation of America.

The study authors suggested improved tree canopy in the city, tree removal mitigation, zoning regulations to create air pollution buffers, and new truck routes. They also suggested the creation of a community asthma notification system.

Barrett said Propeller Health will continue to work with the city and continue to track improvements as these policy recommendations are debated and implemented.

“Policy change occurs on a much slower time scale than does digital health data collection, but we want to ensure that the results from this study can inform decision making into the future in Louisville,” she said.

She expects several more research papers to come out of the program.

The study, “AIR Louisville: Addressing Asthma With Technology, Crowdsourcing, Cross-Sector Collaboration, and Policy.” It was published in the April issue of the journal Health Affairs.

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