DIGITAL inhaler metrics may offer an early signal of impending COPD exacerbations, according to a new pilot study evaluating real-world use of the ProAir Digihaler among high-risk patients. Researchers found that variations in inhalation patterns collected by the device were linked to symptom worsening and clinical flare-ups.
Conducted at two U.S. academic centers, this three-month observational study enrolled patients with confirmed COPD and recent exacerbation history. Participants used the ProAir Digihaler as their primary short-acting beta2-agonist (SABA) inhaler, which recorded detailed inhalation parameters including peak inspiratory flow (PIF), inhalation volume, duration, and frequency of use. A connected mobile app also prompted users to report symptoms when potential exacerbation triggers were detected through the inhaler data.
The study’s primary objective was to assess how these digital metrics varied over time in ambulatory patients. Secondary objectives examined the correlation between inhaler data and monthly COPD Assessment Test (CAT) scores, as well as the agreement between self-reported and actual SABA use. An exploratory analysis looked specifically at changes in inhaler parameters preceding acute exacerbations.
Data revealed that inhalation patterns, particularly PIF and frequency of use, shifted measurably in patients who went on to experience an exacerbation. These trends aligned with worsening symptom reports captured through the app’s daily assessments. Notably, objective inhaler use often diverged from patients’ self-reports, underscoring the limitations of traditional symptom tracking alone.
All study activities, including enrollment and monitoring, were conducted virtually. This design demonstrated feasibility for remote COPD management and digital phenotyping, particularly during periods of healthcare disruption like the COVID-19 pandemic.
The findings support further investigation into digital inhalers as tools for proactive disease monitoring. By enabling early identification of physiologic changes before full-blown exacerbations occur, these devices may help clinicians intervene sooner and improve long-term outcomes for patients with COPD.
Reference:
Drummond MB et al. Use of a digital inhaler to assess COPD disease variability and identify impending acute COPD exacerbations: a pilot study. Chronic Obstr Pulm Dis. 2025;12(3):250-259.
