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Guided Inhalation via Electronic Monitoring in Children With Uncontrolled Asthma (the IMAGINE Study): Randomized
Esther Sportel1, Kris Movig1, Bernard Thio2,3
1Department of Clinical Pharmacy, Medisch Spectrum Twente, Enschede, The Netherlands.
JMIR Pediatrics and Parenting
|November 14, 2025
Summary
Smart inhaler feedback did not improve pediatric asthma control compared to no feedback. However, both groups showed clinical improvements, suggesting a need for adaptive interventions in asthma management.
Area of Science:
- Pediatric Pulmonology
- Digital Health
- Clinical Trials
Background:
- Pediatric asthma is a common chronic illness in the Netherlands, with adherence and technique crucial for control.
- Current hospital visits offer limited insight into these critical parameters.
- Smart inhalers offer potential for home-based monitoring and feedback to improve asthma management.
Purpose of the Study:
- To assess if smart inhaler feedback improves asthma control by enhancing therapy adherence and inhalation technique.
- To evaluate the impact of immediate feedback on clinical outcomes in pediatric asthma patients.
Main Methods:
- The IMAGINE study was a 3-phase randomized controlled trial (RCT).
- Phases included observation, randomization with feedback (intervention) or recording only (control), and final observation.
- Asthma control was measured using lung function tests and validated questionnaires.
Main Results:
- Improvements in clinical parameters (lung function variability, Asthma Control Test scores) were seen in both groups, but no significant difference between groups.
- Predicted forced expiratory volume in 1 second did not improve.
- Inhalation technique and therapy adherence showed no significant differences between the intervention and control groups over time.
Conclusions:
- Smart inhaler feedback alone did not yield superior outcomes compared to standard care.
- Clinical improvements observed in both groups highlight the potential for smart inhaler technology.
- Future research should focus on adaptive, personalized smart inhaler interventions to enhance patient engagement and ownership in asthma management.
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