Digital spacer data driven COPD inhaler adherence education: The OUTERSPACE proof-of-concept study
Boudewijn J H Dierick, Sandra Been-Buck, Titia Klemmeier, Paul Hagedoorn, Susanne J van de Hei, Huib A M Kerstjens, Janwillem W H Kocks, Tanja R Zijp, A Mireille A Wessels, Daan J Touw, Job F M van Boven, Boudewijn J H Dierick, Sandra Been-Buck, Titia Klemmeier, Paul Hagedoorn, Susanne J van de Hei, Huib A M Kerstjens, Janwillem W H Kocks, Tanja R Zijp, A Mireille A Wessels, Daan J Touw, Job F M van Boven
Abstract
Pressurized metered dose inhalers are recommended to be used in combination with spacers, yet inhaler technique and adherence are poor. A novel digital "smart" spacer can record spacer use and technique errors and could facilitate personalized education. In this proof-of-concept study, we assessed the usability of the digital spacer and explored its effects on inhaler technique, adherence, long-term systemic drug exposure and clinical outcomes in COPD. Usability was deemed high. One month after personalized digital spacer inhaler education, the mean number of errors per patient per day decreased with 36%, from 6.40 errors/day to 4.07 errors/day (p = 0.038). Drug exposure was confirmed by bioanalytical scalp hair analysis of formoterol. No significant change in clinical outcomes was observed. This study demonstrates the digital spacer's potential value in inhaler education, but larger, longer-term studies are required.
Conflict of interest statement
Declaration of competing interest HAMK reports a fee for a one time consultancy from Trudell outside the realm of this study, and grants and fees for consultancy or advisory board participation from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Novartis all outside of the submitted work. All were paid to his institution. JWK reports grants, personal fees and non-financial support from AstraZeneca, grants, personal fees and non-financial support from Boehringer Ingelheim, grants and personal fees from Chiesi Pharmaceuticals, grants, personal fees and non-financial support from GSK, grants from Mundi Pharma, grants and personal fees from TEVA, personal fees from MSD, personal fees from COVIS Pharma, outside the submitted work; he holds 72.5% of shares in the General Practitioners Research Institute. DJT received grants from Chiesi and ZonMW outside the submitted work and all paid to his institution. JVB received a grant from Trudell Medical related tot his study, paid to his institution and grants and/or consultancy fees from AstraZeneca, Chiesi, European Commission COST (COST Action 19132 “ENABLE”), GSK, Novartis, Teva, and Trudell Medical, outside the submitted work and all paid to his institution. Other authors declare no relevant conflicts of interest.
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Source: PubMed