Digital Inhalers May Predict COPD Flare-Ups: Study Finds

Digital inhalers may help predict impending acute exacerbations of chronic obstructive pulmonary disease (COPD), according to a new study published in the Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.

Exacerbations, or flare-ups, can cause accelerated loss of lung function, a decrease in quality of life, and reduce a person’s physical function and activity. More than 50% of people with COPD experience at least one acute COPD exacerbation within four years of an initial COPD diagnosis. Increased respiratory rates and decreased lung volumes are early signs of an exacerbation.

The new study examined how digital inhalers using remote monitoring data can help predict and identify early or impending COPD exacerbations. It was an observational pilot study conducted virtually at two U.S. centers between March 2022 and February 2023. It included COPD patients with documented airflow limitation (FEV1/FVC <0.70 and FEV1 ≤80%) and a history of recent exacerbations. After virtual screening and verbal consent, participants received three ProAir Digihaler inhalers by mail and were instructed to use them as their primary short acting beta 2 agonist therapy. App onboarding was done via a central call center.

The digital inhaler used in this study measured peak inspiratory flow, inhalation volume, inhalation duration, time to peak inhalation, and inhaler use. The study examined whether the data collected by the digital inhaler could identify a possible early-stage exacerbation.

“While this study examined a small group of participants, the remote monitoring data showed people experienced significant decreases in the amount of air they inhaled and how long that inhalation lasted in the approximately two weeks prior to experiencing an exacerbation,” said M. Bradley Drummond, M.D., MHS, professor of medicine in the Division of Pulmonary Diseases and Critical Care Medicine at the University of North Carolina, Chapel Hill School of Medicine and lead author of the study. “As these remote monitoring technologies get more advanced, we can help both patients and health care providers identify exacerbations earlier, which allows us to provide better exacerbation management and improve health outcomes.”

Reference: Drummond MB, Hemphill CC, Hill T, Boe A, Yu D, Ohar JA. 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. doi: http://doi.org/10.15326/jcopdf.2024.0555