Using electronic monitoring devices to measure inhaler adherence: a practical guide for clinicians

J Allergy Clin Immunol Pract. May-Jun 2015;3(3):335-49.e1-5. doi: 10.1016/j.jaip.2015.01.024. Epub 2015 Apr 1.


Use of electronic monitoring devices (EMDs) for inhalers is growing rapidly because of their ability to provide objective and detailed adherence data to support clinical decision making. There is increasing potential for the use of EMDs in clinical settings, especially as cost-effectiveness is realized and device costs reduce. However, it is important for clinicians to know about the attributes of different EMDs so that they can select the right device for their patients and understand the factors that affect the reliability and accuracy of the data EMDs record. This article gives information on where to obtain EMDs, describes device specifications, and highlights useful features for the clinician and the patient, including user feedback data. We discuss the benefits and potential drawbacks of data collected by EMDs and provide device users with a set of tools to optimize the use of EMDs in clinical settings, such as advice on how to carry out brief EMD checks to ensure data quality and device reliability. New EMDs on the market require pretesting before use by patients. We provide information on how to carry out EMD pretesting in the clinic and patients' homes, which can be carried out by health professionals or in collaboration with researchers or manufacturers. Strategies for interpreting and managing common device malfunctions are also discussed.

Keywords: Adherence; Electronic devices; Electronics; Equipment and supplies; Materials testing; Medication adherence; Quality control; Remote sensing technology.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Device Approval
  • Drug Administration Schedule
  • Equipment Design
  • Equipment Failure
  • Humans
  • Medication Adherence*
  • Nebulizers and Vaporizers* / standards
  • Pharmaceutical Preparations / administration & dosage*
  • Practice Guidelines as Topic
  • Remote Sensing Technology / instrumentation*
  • Remote Sensing Technology / standards
  • Reproducibility of Results
  • Signal Processing, Computer-Assisted
  • Time Factors
  • United States
  • United States Food and Drug Administration


  • Pharmaceutical Preparations