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Connected Ellipta®: A Case Study of Improved Adherence in Uncontrolled Asthma 

Moore AC.

Respiratory Drug Delivery 2020. Volume 1, 2020: 239-248.

Abstract:

A significant proportion of asthmatic patients are uncontrolled and poor adherence is a key factor. A connected inhaler system (CIS) comprising sensors on the inhaler, a patient application (app), and a Healthcare Professional (HCP) dashboard could empower patients to better manage their disease and HCPs to understand their patients and differentiate between poor adherence and the need to change therapy.

This study investigated the different elements of a CIS in driving a behavioral change in adherence. The study was a 24-week open-label, randomized, multi-center, parallel group design consisting of five treatment arms, in uncontrolled asthmatic patients [Asthma Control Test (ACT) <20] on fixed dose ICS/LABA maintenance therapy. All participants (n=437) received fluticasone furoate/vilanterol Ellipta DPI maintenance therapy and salbutamol metered dose inhaler (MDI) rescue medication with a Propeller Health sensor attached to each inhaler. Participants were randomized to one of five treatment arms as follows: (1) data on maintenance use supplied to participant and HCP; (2) data on maintenance use supplied to participant; (3) data on maintenance and rescue use supplied to participant and HCP; (4) data on maintenance and rescue use supplied to participant; (5) no data supplied to participant or HCP. The study met the primary objective which was to compare the effect of six months use of a CIS on adherence to maintenance therapy assessed over months 4–6; adjusted mean daily adherence was greater in treatment Arm 1 (80.9%) versus Arm 5 (69.0%) (mean difference [95% CI]: 12.0% [5.2%, 18.8%]; p<0.001). For Arms 2, 3, and 4 the adjusted differences were 8.2%, 9.3% and 8.1% respectively compared with Arm 5 and these were all statistically significant at the 5% level. This study demonstrates that a CIS can improve adherence to maintenance therapy for patients with uncontrolled asthma.