Evolution of Technology


The design of inhalers has continued to change over time. From large disks to meter dose pumps, efforts have been made to increase adherence to inhalers by simplifying how it is used. Counters were also added to inhalers to inform patients how many pumps they have remaining in their devices. The counters also allowed the provider to determine how many times the inhaler was used if the device was brought into the office. Outside of these counters providers had to rely on the patient’s recollection of the frequency in which they used the inhaler. This subjective data did not allow for real-time analytics or the formulation of a care management plan based on concrete data. If physicians are not made aware of the improper use of inhalers or lack of use, hospital utilization rates for exacerbations would be difficult to reduce.

Evolution of Diagnosis

Asthma and COPD

Asthma and COPD (chronic obstructive pulmonary disease) are chronic respiratory illnesses. In these conditions, the airways in the lung become inflamed and narrow. This limits the flow of oxygen in and out of the bronchial tubes causing breathing difficulties. The use of an inhaler for acute exacerbations or maintenance is the mainstay of treatment for both conditions. Proper use of inhalers can help to open the airways and reduce inflammation. However, depending on the age of the patient, hand coordination, and lung strength, it may be difficult to properly use inhalers thus reducing adherence. These obstacles would affect the person’s ability to receive symptomatic relief and experience a reduction in the frequency of their exacerbations. Physicians need to be aware of these limitations so that alternative recommendations can be made.