Improving inhaler technique in asthma/COPD by mHealth: a Belgian RCT

Abstract

Introduction: Despite inhalation medication being the main treatment of asthma/COPD patients, only one third of patients demonstrates a correct inhaler technique. While pharmaceutical care has shown to effectively improve inhaler technique, the integration of the MyPuff app to support continued patient education at home has not been evaluated. Aim: To investigate improvement in inhaler technique by integrating a mHealth app compared to standard information leaflets into pharmaceutical care provided to patients with asthma/COPD. Methods: This 3 month Belgian community pharmacy-based open RCT enrolled adult patients, from March till December 2018, with registered inhaler therapy for asthma/COPD. Randomization was stratified according to the 9 community pharmacies to either receive aid for using the MyPuff-app, or a standard information leaflet to further optimize their inhaler technique at home. Inhaler technique was scored by comparing the patient demonstration with the correct protocol per device. Results: Seventy community patients (median age 64y, 56% females; 44% asthma, 39% COPD, 17% ACO) were randomized to the app (n=37; 53%) or leaflet (n=33; 47%). In 60 patients with follow-up, mean score on inhaler technique improved from 49% (SD 28%) to 65% (SD 33%) and the number of patients making critical errors dropped from 52% to 33%. Patients in the app group did not improve more than in the leaflet group. The reported use of the app (13%) was lower than the leaflet use (57%). Conclusion: The inhaler technique of asthma/COPD patients was improved 3 months after pharmaceutical care delivery, however, providing an app to further optimize inhaler technique at home was not better than providing an information leaflet.