ABSTRACT
Modernizing inhaled medications through digital technology can help address persistent problems of non-adherence and poor inhaler technique in patients with obstructive lung diseases. Although available for more than two decades, digital inhaler use in the clinical setting has been modest. However, with advances in digital inhaler sensor technology, in digital telehealth, and more support from payers and healthcare organizations, rapid growth is expected, where by 2030 global sales are projected to be in the billions. There are now several manufacturers of digital inhaler sensors that are either attached to or built into the inhaler. These sensors record inhaler activation and several devices also measure inspiratory flows. Evaluation of these data either in real-time via data transmitted wirelessly to the healthcare professional or at follow-up visits can provide more objective evidence of inhaler use, including adherence and adequacy of inhaler technique. Randomized clinical studies in asthma and chronic obstructive pulmonary disease (COPD) show improved adherence, decreased risk of exacerbations, and improved outcomes. More limited data show improved inhaler technique and cost effectiveness. To implement digital inhalers into clinical practice, one must address cyber security, costs, identifying target patients, and necessary resources. Used as a tool for disease management, digital inhalers facilitate physician–patient relationship and can improve inhaler use and outcomes.
