The Reliability and Patient Acceptability of the SmartTrack Device: A New Electronic Monitor and Reminder Device for Metered Dose Inhalers

Abstract

Objective: The SmartTrack (ST) is a new adherence monitoring device for pressurized metered-dose inhalers (pMDI), with remote upload and ringtone reminder capabilities. Our aim was to assess its reliability and patient acceptability. Methods: Baseline Quality Control (QC): Actuation log accuracy and device functionality tests were undertaken. Simulated Patient Use: Salmeterol/fluticasone inhalers with STs were actuated two times twice daily for 48 h. Accuracy of reminders, data logging, and uploads was tested. Patient Field Testing: Devices were quality tested before dispensing. Asthma patients each field-tested one ST for 7 days and recorded actuations in a diary. Uploaded data were compared to pMDI dose counter and patient diaries. Patient-reported ease of use for the ST was recorded. Results: Baseline QC: 9/10 devices had 100% accuracy; one had an electrical circuit failure. Simulated Patient Use: Accuracy was 99% (2/342 actuations duplicated). Patient Field Testing: One device failed pre-dispensing testing (electrical circuit failure). Eight devices were field-tested by asthma patients (mean age 45, 5 females). Mean actuation log accuracy was 97%. Reminders were 100% accurate. All devices successfully uploaded data. Average patient-rated difficulty of use was 6/100 (1 = extremely easy, 100 = extremely difficult). Conclusions: The ST has acceptable reliability and utility comparable to other electronic monitoring devices. Its remote data upload capability, reminder functions for missed doses, and graphical display of medication use for patient- and physician-feedback are useful additional features.

• adherence
• electronic medication monitoring
• materials testing
• metered-dose inhaler
• patient compliance

Acknowledgments

The authors thank Aaron Skelsey for technical support and Amy Chan for input on methodology. Funding for this study was provided by National Health and Medical Research Council of Australia. Medication was provided by GlaxoSmithKline. ST devices were purchased from Nexus6, Auckland, New Zealand. None of the above bodies had any role in the design, conduct, analysis or interpretation of the study, nor did they see the manuscript prior to submission.

Declaration of Interest

Dr. Foster has received a research grant from GlaxoSmithKline and AstraZeneca and lecture fees from GlaxoSmithKline, Pharmaceutical Society of Australia and AstraZeneca. Dr. Smith has received a research grant from Novo Nordisk and lecture fees from Pharmaceutical Society of Australia. Prof. Rand has participated in advisory boards for TEVA and received consultancy fees for TEVA and Merck. A/Prof. Reddel has participated in advisory boards for AstraZeneca and Novartis, received consultancy fees from GlaxoSmithKline, lecture fees from AstraZeneca, Getz Pharma and MSD, research grants from AstraZeneca and is participating in a data monitoring committee for AstraZeneca, GlaxoSmithKline, Merck, and Novartis. Prof. Sawyer has participated in an advisory board for Astra Zeneca. Prof. Usherwood has no potential conflicts of interest with any companies/organizations whose products or services may be discussed in this article.