ORIGINAL RESEARCH article
Front. Allergy
Sec. Asthma
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1641312
Use of a Digital Rescue Inhaler and At-Home Spirometer in Inner-city Children with Asthma: A Real-World Experience
Provisionally accepted
- 1Children's Hospital of Los Angeles, Los Angeles, United States
- 2University of Southern California, Los Angeles, United States
- 3Teva Pharmaceuticals USA Inc, Parsippany-Troy Hills, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Across all age groups, asthma disproportionally affects inner-city underserved populations. Studies on the use of at-home spirometry and digital inhalers have limited real-world evaluation in pediatric asthma.In this prospective exploratory study, we assessed how an integrated digital rescue inhaler and athome spirometer would affect proper inhaler use, medication adherence, and asthma outcomes using a minimalistic real-world approach. Methods: Twenty-one pediatric asthma patients (8 to 17 years of age) were asked to replace rescue medications with the ProAir Digihaler and perform at-home gamified spirometry daily. Lung function and questionnaires were obtained at baseline and at 3-4 months. Results: Participants were mostly male (81%), Latino/Hispanic (71%), and obese (88th ±16 percentile). Proper rescue inhaler step identification by survey did not change, but inhalation technique based on digital inhaler flow measurements improved for all participants. At-home spirometry was sporadic and reported controller adherence did not change. Younger children (age 8-11) were more severe at baseline (CASI 4.8) compared to older children (CASI of 2.9). For younger children, overall ACT increased by 3.1, CASI decreased by 0.70, and the PedsQL increased by 14 (participants) and 11 (parents). Conclusions: Proper rescue inhaler step identification by survey did not change, but actual inhalation technique based on digital inhaler flow measurements improved. At-home spirometry was sporadic and reported medication adherence did not change. Younger children used the spirometer more frequently and demonstrated improvements in asthma control, severity, and quality of life. These improvements were not observed in older children.
Keywords: Inner-city, Underserved, Asthma, Pediatrics, adherence, digital inhaler, Spirometry, Rescue inhaler
Received: 04 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Izadi, Hill, Boe, Yu and Tam. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Neema Izadi, Children's Hospital of Los Angeles, Los Angeles, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.