• Terence E Taylor, Yaniv Zigel, Céline De Looze, Imran Sulaiman, Richard W Costello, and Richard B Reilly.
• Trinity Centre for Bioengineering, Trinity College Dublin, The University of Dublin, Dublin, Ireland; School of Engineering, Trinity College Dublin, The University of Dublin, Dublin, Ireland. Electronic address: taylorte@tcd.ie.
• Chest. 2018 Mar 1; 153 (3): 710-722.

AbstractHundreds of millions of people worldwide have asthma and COPD. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler and the dry powder inhaler. Provided that they are used as prescribed, inhalers can improve patient clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions, and increased mortality rates, particularly in low- and middle-income countries. There are currently limited methods available to health-care professionals to objectively and remotely monitor patient inhaler adherence. This review describes recent sensor-based technologies that use audio-based approaches that show promising opportunities for monitoring inhaler adherence in clinical practice. This review discusses how one form of sensor-based technology, audio-based monitoring systems, can provide clinically pertinent information regarding patient inhaler use over the course of treatment. Audio-based monitoring can provide health-care professionals with quantitative measurements of the drug delivery of inhalers, signifying a clear clinical advantage over other methods of assessment. Furthermore, objective audio-based adherence measures can improve the predictability of patient outcomes to treatment compared with current standard methods of adherence assessment used in clinical practice. Objective feedback on patient inhaler adherence can be used to personalize treatment to the patient, which may enhance precision medicine in the treatment of chronic respiratory diseases.Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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