A Review of Electronic Devices to Assess Inhaler Technique

  • Delesha M. Carpenter
  • Courtney A. Roberts
  • Adam J. Sage
  • Johnson George
  • Robert Horne
Allergies and the Environment (M Hernandez, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Allergies and the Environment


Purpose of Review

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.).

Recent Findings

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.


Inhaler Metered dose inhaler Dry powder inhaler Inhaler competence Inhaler technique mHealth 



This study was financially supported in part from the PharmAlliance, a three-way partnership between the schools of pharmacy at UNC, UCL, and Monash.

Compliance with Ethical Standards

Conflict of Interest

Mr. Sage Ms. Roberts, and Dr. Carpenter declare no conflicts of interest relevant to this manuscript.

Dr. George has received in-kind support from Vitalograph in the form of devices (COPD-6; ASMA-1; AIM) for pilot testing.

Dr. Horne was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart’s Health NHS Trust; has undertaken speaker engagements with honoraria with the following companies: Abbvie, Amgen, Biogen Idec, Gilead Sciences, GlaxoSmithKline, Janssen, Pfizer, Roche, Shire Pharmaceuticals, MSD, Astellas, Astrazeneca, DRSU, Erasmus, and Novartis; and is founder and shareholder of a UCL business spin out company (Spoonful of Sugar) providing consultancy on medication-related behaviors to healthcare policy makers, providers, and industry.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Delesha M. Carpenter
    • 1
  • Courtney A. Roberts
    • 2
  • Adam J. Sage
    • 2
  • Johnson George
    • 3
  • Robert Horne
    • 4
  1. 1.Eshelman School of PharmacyUniversity of North CarolinaAshevilleUSA
  2. 2.Eshelman School of PharmacyUniversity of North CarolinaChapel HillUSA
  3. 3.Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
  4. 4.School of PharmacyUniversity College LondonLondonUK

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