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. 2023 May 20;33(1):22.
doi: 10.1038/s41533-023-00343-w.

Anticipated barriers and facilitators for implementing smart inhalers in asthma medication adherence management

Susanne J van de Hei  1   2   3 , Nilouq Stoker  3 , Bertine M J Flokstra-de Blok  2   3   4 , Charlotte C Poot  5   6 , Eline Meijer  5   6 , Maarten J Postma  1 , Niels H Chavannes  5   6 , Janwillem W H Kocks  2   3   7   8 , Job F M van Boven  9   10   11   12
Affiliations

Anticipated barriers and facilitators for implementing smart inhalers in asthma medication adherence management

Susanne J van de Hei et al. NPJ Prim Care Respir Med. .

Abstract

Smart inhalers are electronic monitoring devices which are promising in increasing medication adherence and maintaining asthma control. A multi-stakeholder capacity and needs assessment is recommended prior to implementation in healthcare systems. This study aimed to explore perceptions of stakeholders and to identify anticipated facilitators and barriers associated with the implementation of smart digital inhalers in the Dutch healthcare system. Data were collected through focus group discussions with female patients with asthma (n = 9) and healthcare professionals (n = 7) and through individual semi-structured interviews with policy makers (n = 4) and smart inhaler developers (n = 4). Data were analysed using the Framework method. Five themes were identified: (i) perceived benefits, (ii) usability, (iii) feasibility, (iv) payment and reimbursement, and (v) data safety and ownership. In total, 14 barriers and 32 facilitators were found among all stakeholders. The results of this study could contribute to the design of a tailored implementation strategy for smart inhalers in daily practice.

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Conflict of interest statement

J.F.M.v.B.’s institution (UMCG) received consultancy fees, speaking fees and/or research grants from Aardex, AstraZeneca, Chiesi, European Commission COST Action 19132 (ENABLE), GSK, Menarini, Novartis, Pfizer, Teva, Trudell Medical, and Vertex, all unrelated to this study. J.W.H.K. reports grants, personal fees and non-financial support from AstraZeneca, grants, personal fees, and non-financial support from Boehringer Ingelheim, grants and personal fees from Chiesi Pharmaceuticals, grants, personal fees and non-financial support from GSK, non-financial support from Mundi Pharma, grants and personal fees from TEVA, personal fees from MSD, personal fees from COVIS Pharma, grants from Valneva, outside the submitted work; and Janwillem Kocks holds <5% shares of Lothar Medtec GmbH and 72.5% of shares in the General Practitioners Research Institute. B.M.J.F.-d.B. and N.S. were employed by General Practitioners Research Institute (GPRI) at the time of the study. In the past 3 years (2019-2021), GPRI conducted investigator- and sponsor-initiated research funded by non-commercial organisations, academic institutes, and pharmaceutical companies (including AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Mundipharma, Novartis, and Teva). J.F.M.v.B. and N.H.C. are editors for npj Primary Care Respiratory Medicine. They were not involved in the journal’s review of, or decisions related to, this manuscript. Other authors declare no competing interests.

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