1 Department of Medicine, Washington University School of Medicine , St. Louis, Missouri.
2 VA Saint Louis Health System, Saint Louis VA Medical Center , St. Louis, Missouri.
J Aerosol Med Pulm Drug Deliv. 2018 Jun;31(3):191-198. doi: 10.1089/jamp.2017.1383. Epub 2017 Oct 16.
Remote inhaler monitoring is an emerging technology that enables the healthcare team to monitor the time and location of a patient's inhaler use. We assessed the feasibility of remote inhaler monitoring for chronic obstructive pulmonary disease (COPD) patients and the pattern of albuterol inhaler use associated with COPD exacerbations.
Thirty-five participants with COPD used an electronic inhaler sensor for 12 weeks which recorded the date and time of each albuterol actuation. Self-reported COPD exacerbations and healthcare utilization were assessed monthly. We used generalized estimating equations with a logit link to compare the odds of an exacerbation day to a nonexacerbation day by the frequency of daily albuterol use.
Average daily albuterol use on nonexacerbation days varied greatly between patients, ranging from 1.5 to 17.5 puffs. There were 48 exacerbation events observed in 29 participants during the study period, of which 16 were moderate-to-severe exacerbations. During the moderate-to-severe exacerbation days, the median value in average daily albuterol use increased by 14.1% (interquartile range: 2.7%-56.9%) compared to average nonexacerbation days. A 100% increase in inhaler use was associated with increased odds of a moderate-to severe exacerbation (odds ratio 1.54; 95% CI: 1.21-1.97). Approximately 74% of participants reported satisfaction with the sensor.
The electronic inhaler sensor was well received in older patients with COPD over a 12-week period. Increased albuterol use captured by the device was associated with self-reported episodes of moderate-to-severe exacerbations.
远程吸入器监测是一种新兴技术，使医疗团队能够监测患者使用吸入器的时间和地点。我们评估了远程吸入器监测在慢性阻塞性肺疾病（COPD）患者中的可行性，以及与 COPD 加重相关的沙丁胺醇吸入器使用模式。
35 名 COPD 患者使用电子吸入器传感器 12 周，记录每次沙丁胺醇触发的日期和时间。每月评估 COPD 加重和医疗保健利用情况。我们使用广义估计方程和对数链接来比较每日沙丁胺醇使用频率与加重日和非加重日之间的比值比。
在非加重日，患者之间的平均每日沙丁胺醇使用量差异很大，范围为 1.5 至 17.5 喷。在 29 名参与者中观察到 48 次加重事件，其中 16 次为中重度加重。在中重度加重日，与平均非加重日相比，平均每日沙丁胺醇使用量中位数增加了 14.1%（四分位距：2.7%-56.9%）。吸入器使用量增加 100%与中度至重度加重的几率增加相关（比值比 1.54；95%CI：1.21-1.97）。约 74%的参与者对传感器表示满意。
在 12 周的时间内，电子吸入器传感器在年龄较大的 COPD 患者中得到了很好的接受。该设备捕捉到的沙丁胺醇使用量增加与自我报告的中重度加重发作相关。
