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Digital remote maintenance inhaler adherence interventions in COPD: a systematic review and meta-analysis
Hnin Aung1,2, Ronnie Tan1,2, Cara Flynn1,2
1Department of Respiratory Sciences, University of Leicester, Leicester, UK.
Summary
Digital interventions improve inhaler adherence in COPD patients. Healthcare provider-led programs combined with electronic inhaler monitoring (EIM) significantly boost adherence rates, though long-term clinical impact requires further study.
Area of Science:
- Respiratory Medicine
- Digital Health
- Pharmacotherapy Adherence
Background:
- Sub-optimal inhaler adherence is a significant barrier to effective COPD pharmacotherapy.
- Digitalized care pathways offer remote solutions to improve inhaler-use behaviors.
- This review assesses the feasibility and clinical impact of remote electronic inhaler adherence monitoring (EIM) and intervention platforms in COPD management.
Approach:
- Conducted a literature search for studies on digital technology use for maintenance inhaler adherence in COPD patients.
- Performed pairwise and proportional meta-analyses, assessing heterogeneity with I2 statistics.
- Utilized narrative synthesis for outcomes where meta-analysis was not feasible.
Key Points:
- Included 10 studies with 1432 COPD participants using digital inhalers and apps.
- Overall suboptimal inhaler adherence was observed, with variations in calculation methods.
- HCP-led adherence interventions with EIM improved mean adherence by 18% versus passive EIM.
- 85% found digital platforms convenient, and 91% found reminders helpful, despite 14% experiencing technical issues.
Conclusions:
- Digitalized interventions show potential to enhance maintenance inhaler adherence in COPD.
- The overall impact of these interventions on clinical outcomes remains uncertain.
- Further research is needed to personalize interventions and evaluate long-term effects.
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