Personalized Inhaler Training by Pharmacists Improves Adherence in Patients With Asthma

Adherence and health among patients with asthma were improved when community pharmacists led inhaler training using personalized data from an electronic device, according to findings published in the Journal of Allergy and Clinical Immunology in Practice.

“Digital technologies that assess both inhaler adherence and technique have been developed,” authors wrote. “Using these technologies, community pharmacists, who have regular contact with patients, are well placed to deliver personalized inhaler education.”

The cluster randomized study involved 152 participants over the course of 6 months. Participants all had an inhaler compliance assessment device attached to their maintenance inhaler.

There were three study groups: the biofeedback group, whose inhaler training was personalized using data from the device; the demonstration group, whose training involved a physical demonstration with a placebo inhaler; and a control group receiving standard care.

Researchers measured adherence as well as symptoms, exacerbations, and quality-of-life scores using the St George’s Respiratory Questionnaire (SGRQ).

There were 74 participants in the biofeedback group, 56 in the demonstration group, and 22 in the control group. A total of 83 patients had asthma, while 55 patients had chronic obstructive pulmonary disease, and 8 patients had both conditions.

At 2 months, adherence among participants in the biofeedback group was 18% (95% CI, 6-30; P = .004) and 24% higher (95% CI, 9-40; P = .003) than in the demonstration and control groups, respectively. Likewise, at 6 months, the biofeedback group was 14% (95% CI, -1-30; P = .07) and 31% (95% CI, 13-48; P = .001) more adherent than the demonstration and control groups, respectively.

Participants in the biofeedback group also saw significant improvements in daily respiratory symptoms and reduced SGRQ scores by the end of the study period.

“Community pharmacist-delivered inhaler training informed by a digital technology improved adherence and health status,” researchers concluded.

Reference:
O’Dwyer S, Greene G, MacHale E, et al. Personalized biofeedback on inhaler adherence and technique by community pharmacists: a cluster randomized clinical trial. J Allergy Clin Immunol Pract. 2020;8(2):635-644. doi:10.1016/j.jaip.2019.09.008