Electronic monitoring with a digital smart spacer to support personalized inhaler use education in patients with asthma: The randomized controlled OUTERSPACE trial - 31/10/23
Abstract |
Background |
Poor adherence to inhaled medication has been associated with poor outcomes. Smart spacers can monitor inhaler use and technique, yet their feasibility in adults with asthma and their potential benefits are unknown.
Objective |
Assessing the feasibility of undertaking a definitive randomized controlled trial (RCT) of smart spacer-based inhaler education and explore potential clinical benefits in adults with asthma.
Methods |
Two-month randomized controlled feasibility OUtcomes following Tailored Education and Retraining: Studying Performance and AdherenCE (OUTERSPACE) trial comparing personalized smart spacer-based inhaler education versus usual care. Patients were recruited in four Dutch primary care centres. Outcomes were feasibility (inclusion speed, patient acceptance), medication adherence, inhaler technique, clinical effects (lung function, ACQ, FeNO) and usability (System Usability Scale [SUS]).
Results |
42 patients were randomized and all completed the study. The feasibility of performing a larger trial focusing on asthma patient education using a smart spacer was demonstrated with all patients included in four months and a participation rate of 86%. In the intervention group, inhalation errors per day decreased by 26.2% while in the usual care group inhalation errors increased by 14.6% (p = 0.021). Adherence decreased slightly in the intervention group as opposed to improvement in the control group (difference 12%, p = 0.028). No changes in lung function, ACQ or FeNO were observed. Usability was deemed high (SUS patients 71, nurses 89).
Conclusion |
This RCT showed that smart spacer-driven education in patients with asthma is feasible and in this short-term study reduced inhaler errors. Longer-term and larger studies are required to assess clinical effects.
Le texte complet de cet article est disponible en PDF.Highlights |
• | First smart spacer study in asthma patients. |
• | RCT shows that smart spacer-driven education in patients with asthma is feasible. |
• | In the intervention group, inhalation errors per day decreased significantly by 26.2%. |
• | Usability of the smart spacer is deemed high (SUS patients 71, nurses 89). |
Keywords : Asthma, Medication adherence, Valved holding chamber, Persistence, Digital health, Ehealth
Plan
Vol 218
Article 107376- novembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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