Can Pharmacists Improve Adherence to Inhalers with a Digital Health Platform?

Pharmacists and mHealth

Can it help with inhaler adherence rates?

Note: This write-up is based on an in-progress study and not finalized research. I hope to write about this in a year or so when the final results or published.


Using inhalers can be difficult, aside from possible multiple doses required throughout the day, the issue of different device mechanics to administer the drug into the body requires much education for the patient. Compounding this is the factor of low adherence rates amongst pediatric patients who must learn to monitor and take care of themselves over time as well. While digital health is a topic of high interest to myself and is seeing a large growth amongst providers, pharmacist-initiated use is rather limited at this current time. Most of the trials I have seen using digital health interventions for pharmacists to use as a tool to help in direct patient care is predominately outside of the US and centered in Europe at this time. One example is the the "ADolescent Adherence Patient Tool (ADAPT) Study," which is aiming to see if an mHealth intervention can help support self-management and improve adherence in asthma control. 

The Study Design:

The ADAPT study aims to determine if a pharmacy-based intervention platform using digital health tools can improve adherence. The studies intervention will use an app, which will provide:

  1. A questionnaire function to rate asthma symptoms and monitor over time (based on collected data)
  2. Short movie clips with medication and disease information
  3. Medication reminder
  4. Chat function with peers
  5. Chat function with pharmacists

The study will consist of 352 adolescents (12-18 years of age) with asthma and will be conducted in the Netherlands. To read more on the study design, please see here.

What I am Looking Forward To:

This study really intrigues me, as it comes at an interesting time where inhalers are really seeing some interesting design changes. Namely, we have a number of companies (e.g. Propeller, Adherhium, 3M) looking to create 'smart' inhalers with built-in sensors to detect actuation and adherence. While the ADAPT study doesn't use this and will depend on user imputed data (which other studies have demonstrated mixed results with), I find the premise of pharmacists being involved in using data collected to help with interventions very appealing. I feel the next step would be the integration of smart inhalers into a study design such as this, though I want to see if the ADAPT study demonstrates that pharmacists were utilized for insights and what interventions they made.

Kosse RC, Bouvy ML, De vries TW, et al. mHealth intervention to support asthma self-management in adolescents: the ADAPT study. Patient Prefer Adherence. 2017;11:571-577.