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Smart inhalers in paediatric asthma: bridging the gap between innovation and clinical practice
David Drummond1, Job F M van Boven2, Boudewijn J H Dierick3
1Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP, Université Paris Cité, Inserm UMR 1346, Inria, HeKA Team, PariSanté Campus, Paris, France.
Insights
Smart inhaler systems can improve pediatric asthma care by enhancing medication adherence and inhalation technique. These digital tools offer early detection of worsening asthma, transforming patient self-management and outcomes.
Area of Science:
- Pediatric Pulmonology
- Digital Health
- Asthma Management
Background:
- Paediatric asthma outcomes are significantly impacted by medication adherence, inhalation technique, and reliever overuse.
- Smart inhaler systems offer a technological solution to address these challenges in children's asthma care.
Purpose of the Study:
- To review the current evidence on smart inhaler systems in paediatric asthma care.
- To outline the categories of smart inhalers and discuss implementation challenges and future directions.
Main Methods:
- Literature review of smart inhaler systems used in children.
- Categorization of smart inhalers (digital dose counters, smart spacers, smart nebulisers).
- Discussion of implementation barriers and facilitators.
Main Results:
- Smart inhalers can potentially improve medication adherence, inhalation technique, and reduce reliever overuse in children.
- Data from smart inhalers support self-management and early detection of asthma deterioration.
- Key obstacles include technical, behavioral, and health system challenges.
Conclusions:
- Widespread clinical adoption requires clear quality standards, defined indications, EHR integration, and cost-effectiveness data.
- Smart inhaler systems hold significant promise for transforming paediatric asthma care.
- Addressing implementation barriers is crucial for realizing the full potential of these technologies.
Abstract:
Smart inhaler systems represent a major opportunity to transform paediatric asthma care by potentially addressing three fundamental problems affecting paediatric asthma outcomes: medication adherence, inhalation technique and reliever overuse. The data generated across these domains opens up multiple applications - from supporting patient self-management to enabling early detection of asthma deterioration. In this review, we outline the main categories of smart inhalers - including digital dose counters, smart spacers, and smart nebulisers - and summarise the current evidence surrounding their use in children. We discuss key obstacles to implementation, including technical limitations, behavioural factors, and health system-level challenges. Establishing clear smart inhaler systems quality standards, defining appropriate indications resulting in better asthma outcomes, achieving better integration of smart inhaler data into electronic health care records, and generating robust cost-effectiveness data will be essential to support the widespread clinical adoption of these technologies.
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