Published: 4 June 2021

Authors: Alison Moore, Andrew Preece, Raj Sharma, Liam G. Heaney, Richard W. Costello, Robert A. Wise, Andrea Ludwig-Sengpiel, Giselle Mosnaim, Jamie Rees, Ryan Tomlinson, Ruth Tal-Singer, David A. Stempel, Neil Barnes

Source: This abstract has been sourced from NZ Respiratory Research Review Issue 188


    Suboptimal adherence to maintenance therapy contributes to poor asthma control and
    exacerbations. This study evaluated the effect of different elements of a connected inhaler system (CIS),
    comprising clip-on inhaler sensors, a patient-facing app and a healthcare professional (HCP) dashboard,
    on adherence to asthma maintenance therapy.
    This was an open-label, parallel-group, 6-month, randomised controlled trial in adults with
    uncontrolled asthma (asthma control test (ACT) score less than 20) on fixed-dose inhaled corticosteroids/
    long-acting β-agonist maintenance therapy (n=437). All subjects received fluticasone furoate/vilanterol
    ELLIPTA dry-powder inhalers for maintenance and salbutamol/albuterol metered-dose inhalers for rescue,
    with a sensor attached to each inhaler. Participants were randomised to one of five CIS study arms
    (allocation ratio 1:1:1:1:1) reflecting the recipient of the data feedback from the sensors, as follows:
    1) maintenance use to participants and HCPs (n=87); 2) maintenance use to participants (n=88);
    3) maintenance and rescue use to participants and HCPs (n=88); 4) maintenance and rescue use to
    participants (n=88); and 5) no feedback (control) (n=86).
    For the primary endpoint, observed mean±SD adherence to maintenance therapy over months 4–6 was
    82.2±16.58% (n=83) in the “maintenance to participants and HCPs” arm and 70.8±27.30% (n=85) in the
    control arm. The adjusted least squares mean±SE was 80.9±3.19% and 69.0±3.19%, respectively (study arm
    difference: 12.0%, 95% CI 5.2–18.8%; p<0.001). Adherence was also significantly greater in the other CIS
    arms versus the control arm. The mean percentage of rescue medication free days (months 4–6) was
    significantly greater in participants receiving data on their rescue use compared with controls. ACT scores
    improved in all study arms with no significant differences between groups.
    A CIS can improve adherence to maintenance medication and reduce rescue medication use in patients
    with uncontrolled asthma.

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