title: A Review of Electronic Devices to Assess Inhaler Technique.
abstract: OBJECTIVE
  Multiple electronic devices exist that provide feedback on the accuracy of patient inhaler technique. Our purpose is to describe the inhaler technique feedback provided by these devices, including specific technique steps measured, how feedback is displayed, target of feedback (patient, provider, researcher), and compatibility with inhaler type (metered-dose inhaler [MDI], diskus, etc.).
  
  
  RESULTS
  We identified eight devices that provide feedback on inhaler technique. Only one device assessed all evidence-based MDI technique steps. Most devices provide limited real-time feedback to patients, if any feedback at all. Technologies to assess inhaler technique are advancing and hold great potential for improving patient inhaler technique. Many devices are limited in their ability to detect all evidence-based technique steps and provide real-time user-friendly feedback to patients and providers. Usability tests with patients and providers could identify ways to improve these devices to improve their utility in clinical settings.
authors.affiliation: Eshelman School of Pharmacy, University of North Carolina, CPO 2125, Asheville, NC, 28804, USA. dmcarpenter@unc.edu.
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.affiliation: Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Roberts
authors.affiliation: Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Sage
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Johnson
authors.initials: J
authors.lastname: George
authors.affiliation: School of Pharmacy, University College London, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Horne
mesh_terms: D000280:Administration, Inhalation; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D009330:Nebulizers and Vaporizers; D012140:Respiratory Tract Diseases / Q000188:drug therapy*; D012646:Self Administration / Q000592:standards*; D013997:Time Factors
keywords: Dry powder inhaler; Inhaler; Inhaler competence; Inhaler technique; Metered dose inhaler; mHealth