{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:40:21Z","timestamp":1793104821244,"version":"4.5.0"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc"},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."},{"name":"Teva Branded Pharmaceutical Products R&D, Inc."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Prim. Care Respir. Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Electronic inhalers provide information about patterns of routine inhaler use. During a 12-week study, 360 asthma patients using albuterol Digihaler generated 53,083 inhaler events that were retrospectively analyzed. A total of 41,528 (78%) of the recorded inhalation events were suitable for flow analysis (having a PIF\u2009\u2265\u200918\u2009L\/min and &lt;120\u2009L\/min). Median PIF, inhalation volume, inhalation duration, and time to PIF for these events steadily decreased between the first and last 10 days of the study, by 5.1%, 12.6%, 15.9%, and 6.4%, respectively. Continuous short-acting beta<jats:sub>2<\/jats:sub>-agonist (SABA) overuse, defined as \u22652 SABA inhalations\/week throughout the study period, was seen in 29% (<jats:italic>n<\/jats:italic>\u2009=\u2009104) of patients. Of 260 patients with \u22651 instance of acute short-term SABA overuse, 55 (21%) had a confirmed exacerbation. Electronic recording of real-life inhaler use can capture valuable, objective information that could inform disease management and clinical decision-making.<\/jats:p>","DOI":"10.1038\/s41533-024-00382-x","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T18:04:56Z","timestamp":1724177096000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Uncovering patterns of inhaler technique and reliever use: the value of objective, personalized data from a digital inhaler"],"prefix":"10.1038","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-3246","authenticated-orcid":false,"given":"Mark L.","family":"Levy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janwillem W. H.","family":"Kocks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5077-8329","authenticated-orcid":false,"given":"Sinthia","family":"Bosnic-Anticevich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1254-5994","authenticated-orcid":false,"given":"Guilherme","family":"Safioti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Reich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8729-2530","authenticated-orcid":false,"given":"Michael","family":"Depietro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeel","family":"Farooqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Njira L.","family":"Lugogo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanisha","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1528-2146","authenticated-orcid":false,"given":"Henry","family":"Chrystyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"382_CR1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/s41533-017-0016-z","volume":"27","author":"H Chrystyn","year":"2017","unstructured":"Chrystyn, H. et al. Device errors in asthma and COPD: systematic literature review and meta-analysis. NPJ Prim. Care Respir. Med 27, 22 (2017).","journal-title":"NPJ Prim. Care Respir. Med"},{"key":"382_CR2","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1046\/j.1365-2125.2003.01892.x","volume":"56","author":"NR Labiris","year":"2003","unstructured":"Labiris, N. R. & Dolovich, M. B. Pulmonary drug delivery. Part I: physiological factors affecting therapeutic effectiveness of aerosolized medications. Br. J. Clin. Pharm. 56, 588\u2013599 (2003).","journal-title":"Br. J. Clin. Pharm."},{"key":"382_CR3","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.1183\/09031936.00166410","volume":"37","author":"BL Laube","year":"2011","unstructured":"Laube, B. L. et al. What the pulmonary specialist should know about the new inhalation therapies. Eur. Respir. J. 37, 1308\u20131331 (2011).","journal-title":"Eur. Respir. J."},{"key":"382_CR4","doi-asserted-by":"publisher","first-page":"16017","DOI":"10.1038\/npjpcrm.2016.17","volume":"26","author":"ML Levy","year":"2016","unstructured":"Levy, M. L. et al. Inhaler technique: facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT). NPJ Prim. Care Respir. Med 26, 16017 (2016).","journal-title":"NPJ Prim. Care Respir. Med"},{"key":"382_CR5","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1016\/j.jaip.2017.01.004","volume":"5","author":"DB Price","year":"2017","unstructured":"Price, D. B. et al. Inhaler errors in the CRITIKAL study: type, frequency, and association with asthma outcomes. J. Allergy Clin. Immunol. Pr. 5, 1071\u20131081.e1079 (2017).","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"382_CR6","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1038\/s41533-020-00203-x","volume":"30","author":"N Dhadge","year":"2020","unstructured":"Dhadge, N. et al. Monitoring of inhaler use at home with a smartphone video application in a pilot study. NPJ Prim. Care Respir. Med 30, 46 (2020).","journal-title":"NPJ Prim. Care Respir. Med"},{"key":"382_CR7","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1016\/j.rmed.2011.01.005","volume":"105","author":"AS Melani","year":"2011","unstructured":"Melani, A. S. et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir. Med 105, 930\u2013938 (2011).","journal-title":"Respir. Med"},{"key":"382_CR8","doi-asserted-by":"publisher","first-page":"616","DOI":"10.3109\/02770903.2011.580032","volume":"48","author":"L Ovchinikova","year":"2011","unstructured":"Ovchinikova, L., Smith, L. & Bosnic-Anticevich, S. Inhaler technique maintenance: gaining an understanding from the patient\u2019s perspective. J. Asthma 48, 616\u2013624 (2011).","journal-title":"J. Asthma"},{"key":"382_CR9","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1164\/rccm.201604-0733OC","volume":"195","author":"I Sulaiman","year":"2017","unstructured":"Sulaiman, I. et al. Objective assessment of adherence to inhalers by patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med 195, 1333\u20131343 (2017).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"382_CR10","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1089\/jamp.2016.1334","volume":"30","author":"I Sulaiman","year":"2017","unstructured":"Sulaiman, I. et al. The impact of common inhaler errors on drug delivery: Investigating critical errors with a dry powder inhaler. J. Aerosol Med Pulm. Drug Deliv. 30, 247\u2013255 (2017).","journal-title":"J. Aerosol Med Pulm. Drug Deliv."},{"key":"382_CR11","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1016\/j.jaci.2007.02.037","volume":"119","author":"IA Basheti","year":"2007","unstructured":"Basheti, I. A., Reddel, H. K., Armour, C. L. & Bosnic-Anticevich, S. Z. Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists. J. Allergy Clin. Immunol. 119, 1537\u20131538 (2007).","journal-title":"J. Allergy Clin. Immunol."},{"key":"382_CR12","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3109\/02770903.2013.876650","volume":"51","author":"CM Harnett","year":"2014","unstructured":"Harnett, C. M. et al. A study to assess inhaler technique and its potential impact on asthma control in patients attending an asthma clinic. J. Asthma 51, 440\u2013445 (2014).","journal-title":"J. Asthma"},{"key":"382_CR13","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1038\/s41533-018-0110-x","volume":"28","author":"JWH Kocks","year":"2018","unstructured":"Kocks, J. W. H. et al. Systematic review of association between critical errors in inhalation and health outcomes in asthma and COPD. NPJ Prim. Care Respir. Med 28, 43 (2018).","journal-title":"NPJ Prim. Care Respir. Med"},{"key":"382_CR14","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12931-017-0710-y","volume":"19","author":"OS Usmani","year":"2018","unstructured":"Usmani, O. S. et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir. Res 19, 10 (2018).","journal-title":"Respir. Res"},{"key":"382_CR15","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1136\/thx.2009.113662","volume":"64","author":"J Vestbo","year":"2009","unstructured":"Vestbo, J. et al. Adherence to inhaled therapy, mortality and hospital admission in COPD. Thorax 64, 939\u2013943 (2009).","journal-title":"Thorax"},{"key":"382_CR16","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.chest.2016.03.041","volume":"150","author":"J Sanchis","year":"2016","unstructured":"Sanchis, J., Gich, I. & Pedersen, S. Systematic review of errors in inhaler use: Has patient technique improved over time? Chest 150, 394\u2013406 (2016).","journal-title":"Chest"},{"key":"382_CR17","doi-asserted-by":"publisher","first-page":"2556","DOI":"10.1016\/j.jaip.2020.03.013","volume":"8","author":"S Amin","year":"2020","unstructured":"Amin, S., Soliman, M., McIvor, A., Cave, A. & Cabrera, C. Usage patterns of short-acting \u03b2(2)-agonists and inhaled corticosteroids in asthma: A targeted literature review. J. Allergy Clin. Immunol. Pr. 8, 2556\u20132564.e2558 (2020).","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"382_CR18","doi-asserted-by":"publisher","first-page":"e028995","DOI":"10.1136\/bmjopen-2019-028995","volume":"9","author":"EA Azzi","year":"2019","unstructured":"Azzi, E. A. et al. Understanding reliever overuse in patients purchasing over-the-counter short-acting beta(2) agonists: an Australian community pharmacy-based survey. BMJ Open 9, e028995 (2019).","journal-title":"BMJ Open"},{"key":"382_CR19","doi-asserted-by":"publisher","first-page":"4190","DOI":"10.1007\/s12325-020-01444-5","volume":"37","author":"CI Bloom","year":"2020","unstructured":"Bloom, C. I. et al. Asthma-related health outcomes associated with short-acting \u03b2(2)-agonist inhaler use: An observational UK study as Part of the SABINA Global Program. Adv. Ther. 37, 4190\u20134208 (2020).","journal-title":"Adv. Ther."},{"key":"382_CR20","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1016\/j.anai.2021.01.024","volume":"126","author":"N Lugogo","year":"2021","unstructured":"Lugogo, N. et al. Real-world patterns and implications of short-acting \u03b2(2)-agonist use in patients with asthma in the United States. Ann. Allergy Asthma Immunol. 126, 681\u2013689.e681 (2021).","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"382_CR21","doi-asserted-by":"publisher","first-page":"1901872","DOI":"10.1183\/13993003.01872-2019","volume":"55","author":"BI Nwaru","year":"2020","unstructured":"Nwaru, B. I. et al. Overuse of short-acting \u03b2(2)-agonists in asthma is associated with increased risk of exacerbation and mortality: a nationwide cohort study of the global SABINA programme. Eur. Respir. J. 55, 1901872 (2020).","journal-title":"Eur. Respir. J."},{"key":"382_CR22","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1056\/NEJMoa1715274","volume":"378","author":"PM O\u2019Byrne","year":"2018","unstructured":"O\u2019Byrne, P. M. et al. Inhaled combined budesonide-formoterol as needed in mild asthma. N. Engl. J. Med 378, 1865\u20131876 (2018).","journal-title":"N. Engl. J. Med"},{"key":"382_CR23","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.1016\/j.jaip.2022.02.047","volume":"10","author":"JK Quint","year":"2022","unstructured":"Quint, J. K. et al. Short-acting beta-2-agonist exposure and severe asthma exacerbations: SABINA findings from Europe and North America. J. Allergy Clin. Immunol. Pr. 10, 2297\u20132309.e2210 (2022).","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"382_CR24","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1016\/j.jaci.2013.10.028","volume":"133","author":"JF Slejko","year":"2014","unstructured":"Slejko, J. F. et al. Asthma control in the United States, 2008-2010: indicators of poor asthma control. J. Allergy Clin. Immunol. 133, 1579\u20131587 (2014).","journal-title":"J. Allergy Clin. Immunol."},{"key":"382_CR25","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention, https:\/\/ginasthma.org\/wp-content\/uploads\/2022\/07\/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf (2022)."},{"key":"382_CR26","doi-asserted-by":"publisher","first-page":"2101402","DOI":"10.1183\/13993003.01402-2021","volume":"59","author":"ED Bateman","year":"2022","unstructured":"Bateman, E. D. et al. Short-acting \u03b2(2)-agonist prescriptions are associated with poor clinical outcomes of asthma: the multi-country, cross-sectional SABINA III study. Eur. Respir. J. 59, 2101402 (2022).","journal-title":"Eur. Respir. J."},{"key":"382_CR27","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1183\/20734735.008914","volume":"11","author":"ML Levy","year":"2015","unstructured":"Levy, M. L. The national review of asthma deaths: what did we learn and what needs to change? Breathe (Sheff.) 11, 14\u201324 (2015).","journal-title":"Breathe (Sheff.)"},{"key":"382_CR28","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1056\/NEJM199202203260801","volume":"326","author":"WO Spitzer","year":"1992","unstructured":"Spitzer, W. O. et al. The use of beta-agonists and the risk of death and near death from asthma. N. Engl. J. Med 326, 501\u2013506 (1992).","journal-title":"N. Engl. J. Med"},{"key":"382_CR29","doi-asserted-by":"publisher","first-page":"00032","DOI":"10.1183\/23120541.00032-2022","volume":"8","author":"T To","year":"2022","unstructured":"To, T. et al. Is overreliance on short-acting \u03b2(2)-agonists associated with health risks in the older asthma population? ERJ Open Res 8, 00032\u201302022 (2022).","journal-title":"ERJ Open Res"},{"key":"382_CR30","doi-asserted-by":"publisher","DOI":"10.1177\/17534666221116997","volume":"16","author":"CM Averell","year":"2022","unstructured":"Averell, C. M. et al. Impact of adherence to treatment with inhaled corticosteroids\/long-acting \u03b2-agonists on asthma outcomes in the United States. Ther. Adv. Respir. Dis. 16, 17534666221116997 (2022).","journal-title":"Ther. Adv. Respir. Dis."},{"key":"382_CR31","doi-asserted-by":"publisher","first-page":"3846","DOI":"10.21037\/jtd-20-2360","volume":"13","author":"EM Jansen","year":"2021","unstructured":"Jansen, E. M. et al. Global burden of medication non-adherence in chronic obstructive pulmonary disease (COPD) and asthma: a narrative review of the clinical and economic case for smart inhalers. J. Thorac. Dis. 13, 3846\u20133864 (2021).","journal-title":"J. Thorac. Dis."},{"key":"382_CR32","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1164\/rccm.201712-2469LE","volume":"197","author":"B Cushen","year":"2018","unstructured":"Cushen, B. et al. The clinical impact of different adherence behaviors in patients with severe chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med 197, 1630\u20131633 (2018).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"382_CR33","first-page":"e13437","volume":"74","author":"I Hesso","year":"2020","unstructured":"Hesso, I., Nabhani Gebara, S., Greene, G., Co Stello, R. W. & Kayyali, R. A quantitative evaluation of adherence and inhalation technique among respiratory patients: An observational study using an electronic inhaler assessment device. Int J. Clin. Pr. 74, e13437 (2020).","journal-title":"Int J. Clin. Pr."},{"key":"382_CR34","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2147\/PPA.S385857","volume":"17","author":"S Bosnic-Anticevich","year":"2023","unstructured":"Bosnic-Anticevich, S., Bakerly, N. D., Chrystyn, H., Hew, M. & van der Palen, J. Advancing digital solutions to overcome longstanding barriers in asthma and COPD management. Patient Prefer Adherence 17, 259\u2013272 (2023).","journal-title":"Patient Prefer Adherence"},{"key":"382_CR35","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s41030-021-00167-4","volume":"7","author":"AHY Chan","year":"2021","unstructured":"Chan, A. H. Y. et al. Digital inhalers for asthma or chronic obstructive pulmonary disease: A scientific perspective. Pulm. Ther. 7, 345\u2013376 (2021).","journal-title":"Pulm. Ther."},{"key":"382_CR36","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.1016\/j.jaip.2022.06.026","volume":"10","author":"GS Mosnaim","year":"2022","unstructured":"Mosnaim, G. S., Greiwe, J., Jariwala, S. P., Pleasants, R. & Merchant, R. Digital inhalers and remote patient monitoring for asthma. J. Allergy Clin. Immunol. Pr. 10, 2525\u20132533 (2022).","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"382_CR37","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1164\/rccm.201901-0005LE","volume":"199","author":"DA Mahler","year":"2019","unstructured":"Mahler, D. A. Peak inspiratory flow rate: An emerging biomarker in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med 199, 1577\u20131579 (2019).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"382_CR38","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.2147\/JAA.S377631","volume":"15","author":"NL Lugogo","year":"2022","unstructured":"Lugogo, N. L. et al. A predictive machine learning tool for asthma exacerbations: Results from a 12-week, open-label study using an electronic multi-dose dry powder inhaler with integrated sensors. J. Asthma Allergy 15, 1623\u20131637 (2022).","journal-title":"J. Asthma Allergy"},{"key":"382_CR39","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1186\/s12890-023-02566-6","volume":"23","author":"J Kocks","year":"2023","unstructured":"Kocks, J. et al. Identifying critical inhalation technique errors in Dry Powder Inhaler use in patients with COPD based on the association with health status and exacerbations: findings from the multi-country cross-sectional observational PIFotal study. BMC Pulm. Med 23, 302 (2023).","journal-title":"BMC Pulm. Med"},{"key":"382_CR40","doi-asserted-by":"publisher","first-page":"202","DOI":"10.3109\/02770900903581692","volume":"47","author":"M Takemura","year":"2010","unstructured":"Takemura, M. et al. Repeated instruction on inhalation technique improves adherence to the therapeutic regimen in asthma. J. Asthma 47, 202\u2013208 (2010).","journal-title":"J. Asthma"},{"key":"382_CR41","doi-asserted-by":"publisher","first-page":"97","DOI":"10.2147\/COPD.S16173","volume":"6","author":"M Takemura","year":"2011","unstructured":"Takemura, M. et al. Relationships between repeated instruction on inhalation therapy, medication adherence, and health status in chronic obstructive pulmonary disease. Int J. Chron. Obstruct Pulmon Dis. 6, 97\u2013104 (2011).","journal-title":"Int J. Chron. Obstruct Pulmon Dis."},{"key":"382_CR42","unstructured":"FDA. ProAir\u00ae Digihaler\u00ae Prescribing information, https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2019\/205636Orig1s012lbl.pdf (2018)."},{"key":"382_CR43","first-page":"A3941","volume":"197","author":"H Chrystyn","year":"2018","unstructured":"Chrystyn, H., Safioti, G., Buck, D., Ruiter, F. & Blair, J. Justification of the inhalation parameters to provide patients with dose confirmation feedback when they use a digitally enabled albuterol multidose dry powder inhaler (eMDPI). Am. J. Resp. Crit. Care Med 197, A3941 (2018).","journal-title":"Am. J. Resp. Crit. Care Med"},{"key":"382_CR44","doi-asserted-by":"publisher","first-page":"2579","DOI":"10.1016\/j.jaip.2022.08.023","volume":"10","author":"FCL Hoyte","year":"2022","unstructured":"Hoyte, F. C. L. et al. Effectiveness of a digital inhaler system for patients with asthma: A 12-week, open-label, randomized study (CONNECT1). J. Allergy Clin. Immunol. Pr. 10, 2579\u20132587 (2022).","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"382_CR45","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1089\/jamp.2021.0031","volume":"35","author":"H Chrystyn","year":"2022","unstructured":"Chrystyn, H. et al. Investigating the accuracy of the Digihaler, a new electronic multidose dry-powder inhaler, in measuring inhalation parameters. J. Aerosol Med Pulm. Drug Deliv. 35, 166\u2013177 (2022).","journal-title":"J. Aerosol Med Pulm. Drug Deliv."},{"key":"382_CR46","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1089\/jamp.2013.1119","volume":"28","author":"W Azouz","year":"2015","unstructured":"Azouz, W. et al. The inhalation characteristics of patients when they use different dry powder inhalers. J. Aerosol Med Pulm. Drug Deliv. 28, 35\u201342 (2015).","journal-title":"J. Aerosol Med Pulm. Drug Deliv."},{"key":"382_CR47","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1089\/jamp.2023.29103.hc","volume":"36","author":"H Chrystyn","year":"2023","unstructured":"Chrystyn, H., Azouz, W. & Tarsin, W. Dry Powder Inhalers: From Bench to Bedside. J. Aerosol Med Pulm. Drug Deliv. 36, 324\u2013335 (2023).","journal-title":"J. Aerosol Med Pulm. Drug Deliv."},{"key":"382_CR48","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.chest.2016.10.028","volume":"151","author":"M Sadatsafavi","year":"2017","unstructured":"Sadatsafavi, M., Tavakoli, H., Lynd, L. & FitzGerald, J. M. Has asthma medication use caught up with the evidence?: A 12-year population-based study of trends. Chest 151, 612\u2013618 (2017).","journal-title":"Chest"},{"key":"382_CR49","doi-asserted-by":"publisher","first-page":"1701103","DOI":"10.1183\/13993003.01103-2017","volume":"50","author":"PM O\u2019Byrne","year":"2017","unstructured":"O\u2019Byrne, P. M., Jenkins, C. & Bateman, E. D. The paradoxes of asthma management: time for a new approach? Eur. Respir. J. 50, 1701103 (2017).","journal-title":"Eur. Respir. J."},{"key":"382_CR50","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.anai.2012.08.014","volume":"109","author":"RH Stanford","year":"2012","unstructured":"Stanford, R. H., Shah, M. B., D\u2019Souza, A. O., Dhamane, A. D. & Schatz, M. Short-acting \u03b2-agonist use and its ability to predict future asthma-related outcomes. Ann. Allergy Asthma Immunol. 109, 403\u2013407 (2012).","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"382_CR51","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1081\/JAS-200038451","volume":"41","author":"ML Levy","year":"2004","unstructured":"Levy, M. L. et al. Wheeze detection: recordings vs. assessment of physician and parent. J. Asthma 41, 845\u2013853 (2004).","journal-title":"J. Asthma"},{"key":"382_CR52","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.rmed.2004.10.008","volume":"99","author":"EF Juniper","year":"2005","unstructured":"Juniper, E. F., Svensson, K., M\u00f6rk, A. C. & St\u00e5hl, E. Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Respir. Med 99, 553\u2013558 (2005).","journal-title":"Respir. Med"},{"key":"382_CR53","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1164\/rccm.200801-060ST","volume":"180","author":"HK Reddel","year":"2009","unstructured":"Reddel, H. K. et al. An official American Thoracic Society\/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice. Am. J. Respir. Crit. Care Med 180, 59\u201399 (2009).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"382_CR54","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s12890-015-0043-x","volume":"15","author":"W Azouz","year":"2015","unstructured":"Azouz, W., Chetcuti, P., Hosker, H., Saralaya, D. & Chrystyn, H. Inhalation characteristics of asthma patients, COPD patients and healthy volunteers with the Spiromax\u00ae and Turbuhaler\u00ae devices: a randomised, cross-over study. BMC Pulm. Med 15, 47 (2015).","journal-title":"BMC Pulm. Med"}],"container-title":["npj Primary Care Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41533-024-00382-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41533-024-00382-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41533-024-00382-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T18:09:16Z","timestamp":1724177356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41533-024-00382-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,20]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["382"],"URL":"https:\/\/doi.org\/10.1038\/s41533-024-00382-x","relation":{},"ISSN":["2055-1010"],"issn-type":[{"value":"2055-1010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,20]]},"assertion":[{"value":"9 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.L.L. has received payments from publishers Taylor Francis and from Class Publishing; consulting fees from Smart Respiratory; Respiri; Imperial College, AstraZeneca, Novartis, and TEVA; speaker\/writing fees from Chiesi, AstraZeneca, TEVA, and honoraria for manuscript writing and educational events from Consorzio Futuro in Ricerca; fees for expert testimony from HM Coroner, Waltham Forrest, London; support to attend meetings from TEVA; and has held leadership roles (unpaid) in Global Initiative on Asthma (GINA), NHS England, and UK All Party Parliamentary Advisory Group (Asthma). J.W.H.K. reports grants, personal fees and non-financial support from AstraZeneca, grants, personal fees and non-financial support from Boehringer Ingelheim, grants and personal fees from Chiesi, grants, personal fees and non-financial support from GSK, non-financial support from Mundi Pharma, grants and personal fees from Teva, personal fees from MSD, personal fees from COVIS Pharma, grants from Valneva outside the submitted work, and holds <5% shares of Lothar Medtec GmbH and 72.5% of shares in the General Practitioners Research Institute. S.B.-A. received support to provide expert opinion, contribute to advisory boards, deliver expert lectures\/education and\/or undertake independent investigator developed and led research from Teva, AstraZeneca, GSK, Viatris, Boehringer Ingelheim, Ibbvie, Chiesi, Menarini. SB-A is currently employed as Real World Evidence Lead, AstraZeneca, Australia and New Zealand. G.S., M.R., R.B., T.H., and T.L. are employees of Teva Pharmaceuticals. M.D. was an employee of Teva Pharmaceuticals when research was performed, and is currently an employee of Incyte Corporation, Newark, DE, USA. M.C. reports institutional grant funding from NIH, ALA, PCORI, AstraZeneca, GSK, Novartis, Pulmatrix, Sanofi-Aventis, and Shionogi. He receives consulting fees from Allakos, Arrowhead, Genentech, GSK, Merck, Novartis, Sanofi-Aventis, Teva and OM Pharma. He receives payment for speaker\u2019s bureau activities for Amgen, AstraZeneca, Genentech, Regeneron, Sanofi-Aventis, and Teva. He receives royalties from Aer Therapeutics and Elsevier. N.F. receives speaker honoraria from GSK, AstraZeneca, Teva Pharmaceuticals, Regeneron, Genentech, ALK-Abell\u00f3 and Optinose. N.L.L. received consulting fees from Amgen, AstraZeneca, Avillion, Genentech, GSK, Novartis, Regeneron, Sanofi, and Teva; honoraria for non-speakers bureau presentations from GSK, Niox and AstraZeneca; and travel support from AstraZeneca; her institution received research support from Amgen, AstraZeneca, Avillion, Evidera, Gossamer Bio, Genentech, GSK, Regeneron, Sanofi, Novartis and Teva. She is an honorary faculty member of Observational and Pragmatic Research Institute but does not receive compensation for this role. H.C. has no shares in any pharmaceutical companies. He has received sponsorship to carry out studies, together with Board Membership, consultant agreements and honoraria for presentation, from several pharmaceutical companies that market inhaled products. These include Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Innovata Biomed, Meda, MediSage, Menarini, Mundipharma, Napp Pharmaceuticals, Nemera, NorPharma, Norvartis, Orion, Sanofi, Teva, Truddell Medical International, UCB and Zentiva. Research sponsorship has also been received from grant awarding bodies (EPSRC and MRC).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was conducted in full accordance with the Declaration of Helsinki and International Conference on Harmonisation guidelines for Good Clinical Practice. All study documents and procedures were approved by the appropriate Institutional Review Board or Ethics Committee (IRB #201606556). Written informed consent was obtained from each patient before study participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"23"}}