Effectiveness of a Maintenance and Reliever Digihaler System in Asthma: 24-Week Randomized Study (CONNECT2)

J Allergy Clin Immunol Pract. 2024 Feb;12(2):385-395.e4. doi: 10.1016/j.jaip.2023.11.037. Epub 2023 Nov 30.

Abstract

Background: Digital health tools have been shown to help address challenges in asthma control, including inhaler technique, treatment adherence, and short-acting β2-agonist overuse. The maintenance and reliever Digihaler System (DS) comprises 2 Digihaler inhalers (fluticasone propionate/salmeterol and albuterol) with an associated patient App and web-based Dashboard. Clinicians can review patients' inhaler use and Digihaler inhalation parameter data to support clinical decision-making.

Objective: CONNECT2 evaluated asthma control in participants using the DS versus standard-of-care (SoC) maintenance and reliever inhalers.

Methods: Participants (13 years or older) with uncontrolled asthma (Asthma Control Test [ACT] score <19) were randomized 4:3 (open-label) to the DS (n = 210) or SoC (n = 181) for 24 weeks. The primary endpoint was the proportion of patients achieving well-controlled asthma (ie, an ACT score ≥20 or increase from baseline of ≥3 units at week 24).

Results: There was an 88.7% probability that participants using the DS would have greater odds of achieving improvement in asthma control compared with SoC after 24 weeks. The mean odds ratio (95% credible interval) for DS versus SoC was 1.35 (0.846-2.038), indicating a 35% higher odds of improved asthma control with the DS. The DS group had more clinician-participant interactions versus SoC, mainly addressing a poor inhaler technique. DS participants' maintenance treatment adherence was good (month 1: 79.2%; month 6: 68.6%); reliever use decreased by 38.2% versus baseline. App and Dashboard usability was rated "good."

Conclusion: The positive results in asthma control in this study after 24 weeks demonstrate the effectiveness of the DS in asthma management.

Keywords: Adherence; Asthma; Asthma control; Digital inhaler system; Effectiveness; Randomized; SABA usage.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Albuterol / therapeutic use
  • Anti-Asthmatic Agents* / therapeutic use
  • Asthma* / drug therapy
  • Bronchodilator Agents / therapeutic use
  • Budesonide / therapeutic use
  • Drug Combinations
  • Ethanolamines / therapeutic use
  • Formoterol Fumarate / therapeutic use
  • Humans

Substances

  • Budesonide
  • Formoterol Fumarate
  • Ethanolamines
  • Anti-Asthmatic Agents
  • Drug Combinations
  • Albuterol
  • Bronchodilator Agents