J. Allen Meadows, MD: Improving Inhaler Use in Asthma Patients

New technology will allow asthma patients to better understand whether or not they are using their inhalers correctly, which has long been a problem in asthma.

One such product is the Digihaler, a line of digital inhalers developed by Teva Respiratory, an affiliate of Teva Pharmaceuticals, that connects to a smartphone application to alert the user whether or not they are using the inhaler correctly.

In an interview with HCPLive®, J. Allen Meadows, MD, FACAAI, Clinical Faculty, Alabama College of Osteopathic Medicine, explained how the Digihalers work and what he hopes they will accomplish if they are widely used across both pediatric and adult asthma patients.

HCPLive: Can you describe how the Digihaler works?

Meadows: It's a set of inhalers that should meet the needs of many asthma patients. The current Digihaler is a rescue inhaler, ArmonAir is a single ingredient steroid for patients with milder asthma, and then the AirDuo Digihaler would be for more on the higher end of the scale.

And what they'll do for patients is that they're able to be synced with your phone by downloading an app that allows patients and allows the provider to keep up with how they're using their medicine.

HCPLive: It can be a challenge for asthma patients to use their inhaler correctly. Will this give you an alert when someone is not using their inhaler correctly and then you can correct this?

Meadows: There are various research studies done that show as many as 80% of patients with asthma are not able to use their inhalers correctly.

That's a big challenge and with the technology in the Digihaler, it reports to me an inspiratory flow rate. If the patient shares with me, none of this data is given automatically to me, this has to be the patient's choice. It’s actually color coded.

So, the patient pulls out their phone and shows you the app and it shows red if they didn’t inhale as hard as it would be optimal and green shows good inhalation. So very rapidly I can look at that see how their technique is. Inhaler technique is one of the things that people have struggled with for a long time.

HCPLive: Is there a predominate reason why people struggle to use inhalers correctly?

Meadows: Well, there are many different types of inhalers that are available on the market. And so, almost all my patients have one style of inhaler for the rescue inhaler and a different style of their inhaler for their prevention inhaler. Historically, and based on research studies, a lot of patients have challenges using inhalers with coordination. With the Digihaler I just open it and suck but there's not a sequence of steps that have to be followed to get things right.

HCPLive: Do most users believe they are using their inhalers correctly and simply are not?

Meadows: In my practice, the vast majority of patients believe that they are using their inhaler correctly. It’s a challenge with them on that and one of the things with the Digihaler is it is going to let me access that data and maybe even show them objectively. I’m hoping that maybe when this thing is more widespread that both the patient and the provider will be more confident that the inhaler technique is proper.

HCPLive: If some of the incorrect technique is corrected, will there be a drop in asthma-related exacerbations and hospitalizations?

Meadows: That certainly hasn't been looked at with this product because it's relatively new on the market, but my hope would be with better inhaler technique and better adherence we would see fewer exacerbations.

The approval for these products is for the prevention inhalers, one rapid inhalation twice a day. And so, we would expect someone to fill their prevention inhaler on a on a monthly basis. And because of that some of the pharmacies have elected to do auto refill programs.

And so, looking at the pharmacy records is no longer a way that I can find out if they've been compliant. But if with the app, the patient shares that with me electronically, or just shows me the phone I can tell if patients are using their inhalers properly.