OBJECTIVE: To characterize current evidence surrounding DHT platforms among patients with moderate-to-severe asthma in order to compare reported effectiveness across clinical, economic, and humanistic outcomes.
METHODS: This targeted literature review of existing DHT platforms evaluated patient populations, technology interventions, study design, and outcomes in articles published from May 2012-May 2017, and scientific conference abstracts, papers and presentations from May 2015-May 2017.
RESULTS: Included studies (N=31) targeted adult (n=10; 32%), pediatric (n=6; 19%), adolescent (n=2; 6%), and mixed-age (n=10; 8%) asthma populations, or did not specify (n=3; 10%). Study designs included randomized controlled trials (RCTs) (n=16; 52%), prospective observational trials (n=11; 35%), review articles (n=3; 10%), and a meta-analysis (n=1; 3%). Thirty-two unique DHTs were identified, ranging from mobile applications to digital monitoring devices for metered dose and dry powder inhalers. Humanistic outcomes were the most frequently reported category (n=23; 74%), followed by clinical (n=12; 39%), and economic (n=6; 19%) outcomes. Of the RCT studies, comparators included usual care (n=6; 37%) and passive versions (n=10; 63%) of the technology tested (eg, with adherence alerts inactivated).
CONCLUSIONS: Many DHTs are available for patients with moderate-to-severe asthma and the body of evidence on their humanistic, economic and clinical impact is growing. An opportunity exists for a single system which integrates inhaler design, digital technology, and patient engagement to demonstrate further impact on real world outcomes in this patient population.