title: What are the pros and cons of electronically monitoring inhaler use in asthma? A multistakeholder perspective.
abstract: BACKGROUND
  Electronic monitoring devices (EMDs) are the optimal method for collecting objective data on inhaler use in asthma. Recent research has investigated the attitudes of patients with asthma towards these devices. However, no research to date has formally considered the opinions of stakeholders and decision-makers in asthma care. These individuals have important clinical requirements that need to be taken into account if EMDs are to be successfully provisioned, making collecting their opinions on the key barriers facing these devices a valuable process.
  
  
  METHODS
  Three rounds of surveys in a Delphi format were used to assess the most important pros and cons of EMDs for asthma care in a sample of 31 stakeholders which included healthcare professionals and members of clinical commissioning groups.
  
  
  RESULTS
  The respondents identified 29 pros and 32 cons. Pros that were rated as most important included new visual evidence to aid clinical discussions with a patient and an increase in patient involvement and motivation. The cons that were rated as most important included a need for more clinical evidence of the effectiveness of EMDs, as well as better clarity over who has responsibilities in managing, interpreting and discussing data with a patient.
  
  
  CONCLUSIONS
  The research provides a guide for EMD developers by highlighting where these devices may provide the most benefit as well as prioritising the key issues that need addressing if they are to be used effectively in everyday asthma care.
authors.affiliation: Human Factors Research Group , Innovation and Technology Research Centre, University of Nottingham , Nottingham , UK.
authors.forename: Sam
authors.initials: S
authors.lastname: Howard
authors.affiliation: Human Factors Research Group , Innovation and Technology Research Centre, University of Nottingham , Nottingham , UK.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lang
authors.affiliation: Human Factors Research Group , Innovation and Technology Research Centre, University of Nottingham , Nottingham , UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sharples
authors.affiliation: Division of Respiratory Medicine , School of Medicine, Nottingham City Hospital, University of Nottingham , Nottingham , UK.
authors.forename: Dominick
authors.initials: D
authors.lastname: Shaw
keywords: Asthma; Inhaler devices