A new study finds that a sensor-equipped "smart inhaler" can accurately track how—and how well—COPD patients use their medication at home, offering clinicians real-time insights into patient behavior and treatment effectiveness.
Study: Use of a Digital Inhaler to Assess COPD Disease Variability and Identify Impending Acute COPD Exacerbations: A Pilot Study. Image Credit: Tatiana Diuvbanova/Shutterstock.com
Published in the Journal of the COPD Foundation, the pilot study evaluated the Digihaler, a digital rescue inhaler embedded with sensors that log inhalation timing, flow, and volume. The research aimed to assess whether such devices can provide reliable, real-world data on medication adherence and inhalation technique—two critical factors in managing chronic obstructive pulmonary disease (COPD) that are often difficult to measure outside clinical settings.
The Case for Digital Inhalers
Consistent inhaler use and correct technique are essential in COPD care, yet traditional monitoring methods rely heavily on self-reporting, which can be flawed by recall bias or intentional underreporting. Digital inhalers offer a data-driven alternative, automatically capturing each inhalation event and providing detailed usage patterns. These insights could help clinicians spot problems early and personalize treatment more effectively.
Study Design and Approach
The three-month observational study enrolled adults with COPD who had been prescribed the ProAir Digihaler as their primary rescue inhaler. After informed consent and remote training, each participant received three devices. Study staff confirmed proper technique early on, but usage wasn’t monitored in real time. Instead, participants used the devices as they normally would, with optional access to their own data via a companion app.
Researchers collected two types of data: objective metrics from the Digihaler and self-reported outcomes from patients. These included short-acting beta-agonist (SABA) usage, CAT (COPD Assessment Test) scores, and modified Medical Research Council (mMRC) dyspnea scale ratings. Monthly follow-up calls gathered updates on symptoms, exacerbations, and medication use.
Findings and Insights
The devices recorded more than 9600 inhalations over the study period. Daily use varied widely, averaging 2.3 inhalations per day. The average peak inspiratory flow (PIF) was 67.6 L/minute, but nearly 40 % of inhalations were below 60 L/minute, suggesting many patients may not be using their inhalers with optimal force.
About 1 % of inhalations dipped below 30 L/minute, a threshold that could compromise drug delivery. Inhalation volume also varied, highlighting inconsistency in technique across users.
Despite these variations, there was a strong correlation between self-reported and device-recorded SABA use. This suggests that while digital tools provide crucial objective data, patient reports still play a meaningful role in understanding treatment patterns.
Implications for Care
The study shows that smart inhalers like the Digihaler can go beyond simply tracking whether patients are using their medication—they can also reveal how well they're using it. That level of detail could allow clinicians to intervene earlier, correct suboptimal technique, and adjust treatment as needed. It also opens up new opportunities for engaging patients in their own care by giving them direct feedback on their inhaler habits.
As a pilot, this study supports the feasibility of integrating digital inhalers into everyday COPD management and lays the groundwork for larger studies exploring their long-term impact.
Journal Reference
Drummond M. B., Hemphill C. C., et al. (2025). Use of a Digital Inhaler to Assess COPD Disease Variability and Identify Impending Acute COPD Exacerbations: A Pilot Study. Journal of the COPD Foundation, 12(3), 250-259. DOI: 10.2147/COPD.S207621, https://journal.copdfoundation.org/jcopdf/id/1538/Use-of-a-Digital-Inhaler-to-Assess-COPD-Disease-Variability-and-Identify-Impending-Acute-COPD-Exacerbations-A-Pilot-Study