Digital Health: Smart Inhalers

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Allen Amedume, PharmD candidate, and Nikhil A. Sangave, PharmD

Digital Health uses strategic technologies strategically and empowers patients to treat their illnesses, reduce health risks and promote health and wellbeing. This era of digital innovation in our healthcare system offers new alternatives for treating chronic diseases, diagnosing disease earlier, and promoting prevention. The broad spectrum of digital health includes technologies such as mobile health apps (mHealth), artificial intelligence (AI) medical devices, and smartly connected devices

An emerging technology – smart inhalers – is becoming one of the greatest opportunities for clinical pharmacy engagement. Traditional inhalers have long been the main therapy for patients with chronic respiratory diseases. Their ability to deliver drugs (i.e., bronchodilators and corticosteroids) directly to the lungs and significantly reduce systemic side effects is well documented, making them an effective and ideal treatment option

However, health professionals still face various challenges related to the management of respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). Inhaler effectiveness can be affected by improper inhalation techniques and poor adhesion. A recent study showed worsening dyspnea, increased health impairment, and increased frequency of exacerbations associated with improper inhalation technique and non-compliance

In addition, improper inhalation techniques and non-compliance add immensely to health care costs for patients with respiratory diseases. For patients with chronic diseases in the United States, the additional cost of non-compliance alone is estimated at $ 300 billion per year.4 Treating and preventing respiratory disease is considered to be one of the most affordable health interventions available. However, many patients do not optimize their drug therapies. 5

Inadequate inhalation technique or non-compliance with their medication, as a result, can lead to progression of their condition and unnecessary health care costs for patients with respiratory diseases. According to the CDC, if all COPD patients were to fully adhere to their medications, exacerbations could be reduced by 25% to 30% annually, saving $ 4 billion a year

Smart inhalers have the potential to address the challenges patients and healthcare professionals face in treating respiratory diseases. With digital functions for connection to mobile applications, intelligent inhalers and mobile applications simultaneously monitor the medication plans and the subsequent dosage. Smart inhalers can monitor compliance. Record the exact time, date and location of each dose administered; Send dosage reminders; and provide access to easily shared data via Bluetooth. Some smart devices either have sensors inside the inhaler or external sensors that can be connected to traditional inhalers. 7

As the smart inhaler market grows, pharmacists must develop a basic understanding of how to use digital technology to assist patients and healthcare professionals with tools for treating respiratory disease. Nonetheless, approaches to treating respiratory diseases with smart inhalers should be supported by clinical outcomes, designed as a cost-effective system, and reflect the needs of patients and healthcare professionals before they can be generally accepted in practice

Here’s a look at some of the smart inhalers currently on the market in the U.S.

Smart inhalers available internationally:

Intelligent inhalers in development:

REFERENCES

  1. Digital Health Center of Excellence. US Food and Drug Administration. https://www.fda.gov/medical-devices/digital-health. Published in 2020. Accessed November 7, 2020.
  2. Greene, G. and Costello, R., 2019. Personalizing Medicine – Could the Smart Inhaler Revolutionize the Treatment of COPD and Asthma Patients? Expert Opinion on Drug Delivery, 16 (7), pp. 675-677.
  3. Ngo CQ, Phan DM, Vu GV et al. Inhalation technique and inhalation medication compliance in patients with acute exacerbation of chronic obstructive pulmonary disease in Vietnam. Int J Environ Res Public Health. 2019; 16 (2): 185. Published 2019 Jan 10. doi: 10.3390 / ijerph16020185
  4. Lareau SC, yawn BP. Improving adherence to inhalation therapy in COPD. Int J Chron Obstruct Pulmon Dis. 2010; 5: 401- 406. Published on November 24, 2010 doi: 10.2147 / COPD.S14715
  5. 2017. The global impact of respiratory disease. 2nd ed. Sheffield: European Respiratory Society, p.6.
  6. Pal S. Epidemiology of Chronic Lung Diseases. Uspharmacist.com. https://www.uspharmacist.com/article/epidemiology-of-chronic-lung-diseases. Published in 2020. Accessed November 7, 2020.
  7. An analysis of the Smart Inhalers Market. Medical device outsourcing. https://www.mpo-mag.com/contents/view_online-exclusives/2020-06-09/an-analysis-of-the-smart-inhalers-market/. Published in 2020. Accessed November 7, 2020.
  8. Blakey JD, Bender BG, Dima AL, Weinman J, Safioti G, Costello RW. Digital Technologies and Respiratory Disease Compliance: The Way Forward. Eur Respir J. 2018; 52 (5): 1801147. Published on November 22, 2018. doi: 10.1183 / 13993003.01147-2018
  9. Propeller Health Sensor is packaged together with recently approved Enerzair® Breezhaler® asthma medication in Europe. Businesswire.com. https://www.businesswire.com/news/home/20200706005585/de/Propeller-Health-Sensor-Co-Packaged-Approved-Enerzair%C2%AE-Breezhaler%C2%AE. Published in 2020. Accessed November 7, 2020.
  10. Teva Announces Availability of ProAir® Digihaler® (Albuterol Sulphate 117 mcg) Inhalation Powder for Patients with Asthma and COPD. Businesswire.com. https://www.businesswire.com/news/home/20200713005034/de/Teva-Announces-Availability-of-ProAir%C2%AE-Digihaler%C2%AE-albuterol-sulfate-117-mcg-Inhalation-Powder- for patients with asthma and COPD. Published in 2020. Accessed November 7, 2020.
  11. Teva is launching two digital inhalers in the US, AirDuo® Digihaler® (fluticasone propionate and salmeterol), powder inhalation and ArmonAir® Digihaler® (fluticasone propionate), powder inhalation. Businesswire.com. https://www.businesswire.com/news/home/20200921005170/de/Teva-Launches-Two-Digital-Inhalers-in-the-US-AirDuo%C2%AE-Digihaler%C2%AE-fluticasone-propionate- and-salmeterol-inhalable-powder-and-ArmonAir% C2% AE-Digihaler% C2% AE-fluticasone propionate-inhalable powder. Published in 2020. Accessed November 7, 2020.
  12. How it works | Hailie ™. Hail. https://www.hailie.com/pages/how-it-works. Published in 2020. Accessed November 7, 2020.
  13. FindAir – Smart Inhaler. Findair.eu. https://findair.eu/#Produkt. Published in 2020. Accessed November 7, 2020.
  14. Lupine launches “Adhero”, the first networked smart device of its kind in India to support the treatment of respiratory diseases – lupine. Lupine. https://www.lupin.com/portfolio/lupin-launches-adhero-first-of-its-kind-connected-smart-device-in-india-to-support-treatment-of-respiratory-disease/. Published in 2020. Accessed November 7, 2020.
  15. 3M Develops “Smart Inhalation System” for COPD, Asthma and Other Respiratory Diseases – Lung Disease News. Lung disease news. https://lungdiseasenews.com/2016/04/22/3m-designs-intelligent-inhaler-system-copd-asthma-respiratory-ills/. Published in 2020. Accessed November 7, 2020.
  16. Virtual tour to the BreatheSmart® Mobile App – HeroTracker® sensors. Coherohealth.com. https://coherohealth.com/BreatheSmart/demo/sensors.php. Published in 2020. Accessed November 7, 2020.
  17. Pharmaceutical company Opko is acquiring a smart inhaler startup for at least $ 10 million. MobiHealthNews. https://www.mobihealthnews.com/32207/pharma-company-opko-acquires-smart-inhaler-startup-for-at-least-10m. Published in 2020. Accessed November 7, 2020.
  18. Inspair | Biocorp. Biocorpsys.com. https://biocorpsys.com/de/our-products/connected-devices/inspair/. Published in 2020. Accessed November 7, 2020.
  19. Pneuma Respiratory debuts with a smartphone-compatible inhaler. MobiHealthNews. https://www.mobihealthnews.com/content/pneuma-respiratory-debuts-smartphone-compatible-inhaler. Published in 2020. Accessed November 7, 2020.
  20. Amiko | Improve airway care. Amiko. https://amiko.io/. Published in 2020. Accessed November 7, 2020.

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