Parent perspectives on the potential use of smart inhalers for asthma management in children: a qualitative interview study

Achieving adequate adherence to preventer medication remains a challenge in the management of paediatric asthma. A minimum of 75% adherence is recommended to achieve adequate clinical control, however actual adherence rates are often lower and are influenced by the unpredictability of family life and competing demands. Smart inhalers aim to support adherence to preventer medications by monitoring use and providing medication reminders, as well as tracking reliever use. This study explored the perceptions of parents of children aged 5-9 years with recent uncontrolled asthma regarding the potential usefulness of smart inhalers to manage their children's asthma, and perceived barriers and facilitators to their use. Semi-structured interviews were conducted via Zoom with parents residing in New South Wales, Australia. Interviews explored parents' perspectives about barriers to asthma management, awareness and perceived need for smart inhalers, desired features and functionalities, attitudes towards data sharing, perceived support requirements and cost considerations. Data were analysed using a hybrid inductive analysis approach. Ten parents participated (children aged 5-8); none had previously used a smart inhaler to manage their child's asthma. Overall attitudes toward smart inhalers were positive. Four primary themes were identified: perceived benefits of smart inhalers, including access to reliable medication data to share with healthcare providers; barriers to adoption, including concerns about technology difficulties; cost considerations with affordability influencing the likelihood of uptake; and implementation needs including the need for support for initial set up. Parents generally viewed smart inhalers as a promising tool for managing childhood asthma. Study findings suggest that successful implementation will require consideration of cost, ease of use, and adequate support for use.