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Objective: Adherence and inhaler technique are often suboptimal in asthma and chronic obstructive pulmonary disease (COPD). New inhalers have been developed to improve these determinants of treatment effectiveness. We assessed treatment adherence, satisfaction, and ease of use of DuoResp ® Spiromax ® among SPRINT study participants. Methods: The Phase IV SPRINT study was conducted in 10 European countries. Asthma and COPD patients were receiving a fixed-dose combination of inhaled corticosteroid (ICS) and long-acting β 2 -agonist (LABA), delivered via various inhalers including DuoResp Spiromax. DuoResp Spiromax users self-assessed adherence using the 8-item Morisky Medication Adherence Scale (MMAS-8 ® ), and ease of use and satisfaction using 10-point scales, during a single physician's office visit. Results: Of 1661 (asthma: n  = 1101; COPD: n  = 560) SPRINT study participants, 342 (asthma: n =  235; COPD: n =  107) received DuoResp Spiromax prior to inclusion. Overall, 72.5% of DuoResp Spiromax users reported medium or high adherence (MMAS-8 score ≥6). Mean (standard deviation [SD]) satisfaction score for DuoResp Spiromax was 8.9 (1.6). Almost all (98.8%) DuoResp Spiromax users were at least satisfied with their inhaler; 85.4% were very satisfied. Mean (SD) ease of use score for DuoResp Spiromax was 9.1 (1.3). Conclusions: Asthma and COPD patients using DuoResp Spiromax reported moderate-to-high medication adherence, were very satisfied with their inhaler and found it easy to use.

Outcomes for patients with chronic respiratory diseases remain poor despite the development of novel therapies. In part, this reflects the fact that adherence to therapy is low and clinicians lack accurate methods to assess this issue. Digital technologies hold promise to overcome these barriers to care. For example, algorithmic analysis of large amounts of information collected on health status and treatment use, along with other disease relevant information such as environmental data, can be used to help guide personalised interventions that may have a positive health impact, such as establishing habitual and correct inhaler use. Novel approaches to data analysis also offer the possibility of statistical algorithms that are better able to predict exacerbations, thereby creating opportunities for preventive interventions that may adapt therapy as disease activity changes. To realise these possibilities, digital approaches to disease management should be supported by strong evidence, have a solid infrastructure, be designed collaboratively as clinically effective and cost-effective systems, and reflect the needs of patients and healthcare providers. Regulatory standards for digital interventions and strategies to handle the large amounts of data generated are also needed. This review highlights the opportunities provided by digital technologies for managing patients with respiratory diseases., Competing Interests: Conflict of interest: J.D. Blakey reports personal fees (for an advisory board meeting) from Teva, personal fees (for travel and lectures) and non-financial support from Napp, personal fees (for a presentation) from Novartis, personal fees and non-financial support (for travel and lectures) from AstraZeneca, and personal fees and non-financial support (for travel and lectures) from Boehringer Ingelheim, outside the submitted work. B.G. Bender has nothing to disclose. Conflict of interest: A.L. Dima reports grants and non-financial support (for travel and research) from Respiratory Effectiveness Group, outside the submitted work. Conflict of interest: J. Weinman reports personal fees from Atlantis Healthcare, Boehringer Ingelheim, Chugai/Roche, Ferring, Sanofi and Teva, and grants from Merck, outside the submitted work. Conflict of interest: G. Safioti is an employee of Teva. Conflict of interest: R.W. Costello has received funding for research from Aerogen and GSK, speaker's and consultancy fees from Aerogen, Boehringer Inghelheim, AstraZeneca, GSK, Novartis and Teva. He has licensed an acoustic device to assess adherence to Vitalograph and has a patent pending for the identification of inhaler use (P10961USPC) and two pending for methods to assess adherence and remotely predict exacerbations., (Copyright ©ERS 2018.)