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2. ENGINEERING AND TECHNOLOGY, 2.3 MECHANICAL ENGINEERING
Electronic monitors are considered the gold standard for objectively quantifying adherence to inhaled therapy (1). Most studies using electronic recording devices have reported adherence as the mean adherence, or the mean daily dose, over the study period (2–4). However, this method does not reflect variations in the way that patients use their treatments. For example, the mean adherence is the same whether an individual took the medication according to the prescribed schedule or took all the doses in the first half of a dosing period, leaving none in the second half. Inhaler technique must be included in the assessment of adherence because an individual may use his/her inhaler according to the dosing schedule but with incorrect technique, resulting in no medication being delivered. In this case, the average use over time is meaningless unless data on the technique of use are also incorporated into the calculation of adherence. Most electronic recording devices do not assess whether the inhaler was used correctly (5–12). Hence, there is a need to develop a method to quantify adherence that accounts for variations in dosing schedules as well as inhaler user technique.
Costello RC.et al. (2016) A Method to Calculate Adherence to Inhaled Therapy That Reflects the Changes in Clinical Features of Asthma. Ann Am Thorac Soc, 2016. doi:10.1513/AnnalsATS.201603-222OC