Mosnaim Giselle S, Greiwe Justin, Jariwala Sunit P, Pleasants Roy, Merchant Rajan
Division of Allergy, Asthma and Immunology, Department of Medicine, NorthShore University HealthSystem, Evanston, Ill.
Bernstein Allergy Group, Inc, Cincinnati, Ohio; Division of Immunology/Allergy Section, Department of Internal Medicine, The University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Allergy Clin Immunol Pract. 2022 Oct;10(10):2525-2533. doi: 10.1016/j.jaip.2022.06.026. Epub 2022 Jun 29.
Digital inhaler systems, remote patient monitoring, and remote therapeutic monitoring offer great promise as diagnostic tools and therapeutic interventions to improve adherence and inhaler technique for patients with difficult-to-control asthma. In turn, improvements in adherence and inhaler technique may translate into decreasing the need for high side effect treatments such as oral corticosteroids and costly therapies including biologics. Although more clinical trials are needed, studies that use digital inhaler systems to collect objective real-time data on medication-taking behavior via electronic medication monitors and feed this data back to patients on their mobile asthma app, and to health care professionals on the clinician dashboard to counsel patients, show positive outcomes. This article addresses the use of these diagnostic and therapeutic tools in asthma care, how to choose a digital inhaler system, how to teach patients to use the system, strategies for the adoption of these technologies in large health care systems as well as smaller practices, coding and reimbursement, liability concerns, and research gaps.
数字吸入器系统、远程患者监测和远程治疗监测作为诊断工具和治疗干预手段，有望极大地改善难治性哮喘患者的依从性和吸入器使用技术。反过来，依从性和吸入器使用技术的改善可能会减少对口服皮质类固醇等高副作用治疗以及包括生物制剂在内的昂贵疗法的需求。尽管还需要更多的临床试验，但使用数字吸入器系统通过电子药物监测器收集关于用药行为的客观实时数据，并将这些数据在患者的移动哮喘应用程序上反馈给患者，以及在临床医生仪表板上反馈给医疗保健专业人员以指导患者的研究显示出了积极的结果。本文探讨了这些诊断和治疗工具在哮喘护理中的应用、如何选择数字吸入器系统、如何教导患者使用该系统、在大型医疗保健系统以及小型医疗机构中采用这些技术的策略、编码和报销、责任问题以及研究空白。
