Advances in Audio-Based Systems to Monitor Patient Adherence and Inhaler Drug Delivery

Chest. 2018 Mar;153(3):710-722. doi: 10.1016/j.chest.2017.08.1162. Epub 2017 Sep 5.

Abstract

Hundreds of millions of people worldwide have asthma and COPD. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler and the dry powder inhaler. Provided that they are used as prescribed, inhalers can improve patient clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions, and increased mortality rates, particularly in low- and middle-income countries. There are currently limited methods available to health-care professionals to objectively and remotely monitor patient inhaler adherence. This review describes recent sensor-based technologies that use audio-based approaches that show promising opportunities for monitoring inhaler adherence in clinical practice. This review discusses how one form of sensor-based technology, audio-based monitoring systems, can provide clinically pertinent information regarding patient inhaler use over the course of treatment. Audio-based monitoring can provide health-care professionals with quantitative measurements of the drug delivery of inhalers, signifying a clear clinical advantage over other methods of assessment. Furthermore, objective audio-based adherence measures can improve the predictability of patient outcomes to treatment compared with current standard methods of adherence assessment used in clinical practice. Objective feedback on patient inhaler adherence can be used to personalize treatment to the patient, which may enhance precision medicine in the treatment of chronic respiratory diseases.

Keywords: COPD; adherence; asthma; inhalers.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage*
  • Anti-Asthmatic Agents / administration & dosage*
  • Asthma / drug therapy*
  • Bronchodilator Agents / administration & dosage*
  • Equipment Design
  • Humans
  • Medication Adherence*
  • Nebulizers and Vaporizers*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Quality of Life
  • Sound*

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents
  • Bronchodilator Agents