Many patients with asthma and/or COPD are dependent on inhalers to administer their medication. These devices are however difficult to use and require optimal inhaler technique and adherence. In daily practice, an estimated 70% of patients with asthma/COPD makes inhaler errors and around 50% have difficulties with adherence. Suboptimal inhaler use results in lower drug deposition in the lungs and as such less patient benefit. Notably, non-adherence to inhalers has been associated with more hospital admissions, lower quality of life and more work absence. Therefore, pressurized metered dose inhalers, used by over half of patients, are recommended to combined with a spacer. A spacer can enhance lung deposition, but healthcare professionals have no insight into its actual use. A novel digital spacer can measure inhaler errors and adherence to inhalers and could potentially be used to tailor education around proper inhaler use. At MAECON, we have first validated the performance of the spacer versus the original spacer at the University of Groningen’s inhalation lab to check any discrepancies in internal resistance. Subsequently, we designed and performed the OUTERSPACE clinical trial program in which we assess its usability and test the clinical effects of this novel digital spacer in patients with asthma and COPD. Studies are performed in the primary care and the hospital setting. Outcomes include inhaler errors, adherence, lung function, quality of life, work absence and concentrations of inhaled drugs in scalp hair as analyzed by our bioanalytical lab at the University Medical Center Groningen.
Funding: Trudell Medical International (Ontario, Canada)
Dierick B et al. Can electronic monitoring with a digital smart spacer support personalised medication adherence and inhaler technique education in patients with asthma?: Protocol of the randomised controlled OUTERSPACE trial. BMJ Open 2022