A Method to Assess Adherence in Inhaler Use through Analysis of Acoustic Recordings of Inhaler Events

Authors

Shona D’Arcy, Trinity College Dublin, Dublin, Ireland
Elaine MacHale, Royal College of Surgeons in Ireland
Jansen Seheult, Royal College of Surgeons in Ireland
Martin S. Holmes, Trinity College Dublin, Dublin, Ireland
Cian Hughes, Trinity College Dublin, Dublin, Ireland
Imran Sulaiman, Royal College of Surgeons in Ireland
Deirdre Hyland, Royal College of Surgeons in Ireland
Conor O’Reilly, Royal College of Surgeons in Ireland
Senan Glynn, Royal College of Surgeons in Ireland
Thekra Al-Zaabi, Royal College of Surgeons in Ireland
John McCourt, Dublin Centre for Clinical Research, Dublin, Ireland
Terence Taylor, Vitalograph, Ennis, Co Clare, Ireland
Frank Keane, Vitalograph, Ennis, Co Clare, Ireland
Isabelle Killane, Technological University DublinFollow
Richard B. Reilly, Trinity College Dublin, Dublin, Ireland
Richard W. Costello, Royal College of Surgeons in Ireland

Document Type

Article

Rights

Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence

Disciplines

2. ENGINEERING AND TECHNOLOGY

Publication Details

PLoS One. 2014 Jun 6;9(6):e98701. doi: 10.1371/journal.pone.0098701. eCollection 2014

Abstract

Rationale: Poor adherence to inhaler use can be due to poor temporal and/or technique adherence. Up until now there has been no way of reliably tracking both these factors in everyday inhaler use. Objectives: This paper introduces a device developed to create time stamped acoustic recordings of an individual’s inhaler use, in which empirical evidence of temporal and technique adherence in inhaler use can be monitored over time. The correlation between clinical outcomes and adherence, as determined by this device, was compared for temporal adherence alone and combined temporal and technique adherence. Findings: The technology was validated by showing that the doses taken matched the number of audio recordings (r2 = 0.94, p,0.01). To demonstrate that audio analysis of inhaler use gives objective information, in vitro studies were performed. These showed that acoustic profiles of inhalations correlated with the peak inspiratory flow rate (r2 = 0.97, p, 0.01), and that the acoustic energy of exhalations into the inhaler was related to the amount of drug removed. Despite training, 16% of participants exhaled into the mouthpiece after priming, in .20% of their inhaler events. Repeated training reduced this to 7% of participants (p = 0.03). When time of use was considered, there was no evidence of a relationship between adherence and changes in AQLQ (r2 = 0.2) or PEFR (r2 = 0.2). Combining time and technique the rate of adherence was related to changes in AQLQ (r2 = 0.53, p = 0.01) and PEFR (r2 = 0.29, p = 0.01). Conclusions: This study presents a novel method to objectively assess how errors in both time and technique of inhaler use impact on clinical outcomes.

DOI

https://doi.org/10.1371/journal.pone.0098701

Recommended Citation

D’Arcy S, MacHale E, Seheult J, Holmes MS, Hughes C, et al. (2014) A Method to Assess Adherence in Inhaler Use through Analysis of Acoustic Recordings of Inhaler Events. PLoS ONE 9(6): e98701. doi:10.1371/journal.pone.0098701