Adherence to inhaled steroids treatment using smart nebulisers in severe asthmatics

Incorrect inhaler use and poor adherence are the most common reasons for patients failing to achieve good asthma control1. The AKITA JET nebuliser system employs flow- and volume-controlled inhalation technology (FAVORITETM) to guide the patient in the correct inhalation technique. Data on adherence for review by the treating physician is collected by a smart card. Aim: To assess treatment adherence in a study comparing the steroid-sparring effect of budesonide inhalation suspension administered using the AKITA JET nebuliser system in adult patients with severe asthma2. Methods: Daily use of the AKITA JET smart nebuliser was recorded in a randomised, placebo-controlled study of 158 subjects with severe asthma comparing the steroid-sparing effect of budesonide (1mg and 0.5mg) with that of placebo administered BID for 18 weeks. A smart card attached to the device recorded each treatment, duration and breathing manoeuvers performed during inhalation. Dose compliance was expressed as % of successful / expected doses. Results: Treatment compliance was 82% for all patients. 84% of patients inhaled an aerosol volume ≥ 1 L/breath and 35% achieved the maximum aerosol inhalation volume of 1.4 L/breath. The average time to complete treatment was 13 min 33 sec. Conclusions: Treatment with smart nebulisers such as Akita JET help patients achieve the correct inhalation technique, deliver drug more efficiently to the lungs, as well as monitor treatment compliance. These attributes could improve patient outcomes in severe asthma, leading to improved patient satisfaction and adherence in a real world setting. 1 2017 GINA Report; http://ginasthma.org 2 Vogelmeier et al, Eur Resp Jour 2014; DOI: 10.1183/09031936.00152014