Smart Inhalers: Pros and Cons

by Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional

Smart inhalers are devices that use electronic monitoring attached to the internet to track medication, dosage, and time taken for each inhaled dose. These devices are poised to expand into the marketplace in the coming years and, according to Market Watch, the market is expected to reach $191 million by 2022. While it sounds like the products have a blanket seal of approval there are still studies being done to determine whether the benefits of smart inhalers outweigh their drawbacks.

A study published by the BMJ Open Respiratory Research Journal sought to answer the question “What are the pros and cons of electronically monitoring inhaler use in asthma?” Several pros and cons for using smart inhalers were listed in the study’s findings.

The most important pros of the devices include:

  • Better asthma control and improved quality of life.

  • Aiding discussions between clinicians and patients.

  • Patients’ awareness of monitoring may improve their compliance.

  • Increased patient involvement and motivation for treating their condition.

  • More informed decision-making (based on real, not reported usage) for clinicians.

All of these pros are of great importance in determining whether the use of a smart inhaler is beneficial for the patient. Getting the patient more motivated and empowered over their own care, while providing real-time hard data for the clinician has the potential to improve outcomes in asthma control. More studies are needed to determine whether these benefits prove true over long-term use.

The most important cons from the study were:

  • Evidence of the effectiveness of electronic monitoring devices is not known.

  • Patients may not like being watched by “big brother” via the internet-based monitoring component.

  • A smart inhaler could interfere with a patient’s usual inhalation technique or be incompatible with some spacers.

  • Products lacked a definition for whose responsibility it would be to download, process and interpret the data.

  • An electronic monitoring device may be required for more than one inhaler per patient.

  • Accuracy and reliability of the device, as well as potential technical issues, are not known.

As the parent of two asthmatics, some of these cons are definitely things I have considered. For example, we have multiple inhalers. Each of our children have three different medications and duplicate inhalers at school, which could present an issue in recording accurate data regarding their usage. Compatibility with spacers, cost of the device and dealing with tech issues also could deter some from using smart inhalers.

While the study did find more cons than pros for smart inhalers, most concerns come from a lack of understanding the product. If questions regarding the cost, technology and ease of use were clearer to patients and clinicians, they might become more widely used. The devices won’t be of much help to patients until their physicians are able to collect and interpret the data for all inhalers in a cohesive manner. Until then, physicians will still rely on patients to report their compliance.

Hopefully, in the next few years, smart inhalers will become more streamlined and the kinks will be worked out. There will always be people who are unwilling to be monitored in this way, or who are not tech savvy and thus avoid the smart devices all together. Again, in those instances, clinicians will be back to relying on the patient’s report of their medication compliance. But, for many patients, who are already using smart devices, these smart inhalers could prove key in improving asthma control.


Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).

Jennifer Mitchell Wilson
Meet Our Writer
Jennifer Mitchell Wilson

Jennifer Mitchell Wilson is a dietitian and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and has done graduate work in public health and nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.