Turbu+TM (AstraZeneca, Cambridge, UK)
The SmartTurbo/Hailie EMD has been used by AstraZeneca to launch Turbu+. The Turbu+ consists of three components, the electronic device that attaches to a Turbohaler, an application for the patients and an online portal allowing HCPs access to the same actuation data(43). During inhalation, the date and time of actuation is recorded, but inhaler technique is not assessed. Scheduled reminders can be set by the patients and if a dose was not taken 30 minutes after the scheduled inhalation, a “missed-medication” motivational message is sent automatically. Patients also receive a weekly motivational push notification in the application (e.g. ‘Great week. You’ve been following your prescription this week! Keep it up!”)(44).
In a small real-world study including 32 adult asthma patients, the number of actuations recorded by the EMD was compared to patient reported inhalations. A total of 932 medication doses were verified by the EMD with a total of 796 doses (85.4%) registered by the patient. A false positive rate of 3.5% was registered (patient recorded but not EMD recorded) as well as a false negative rate of 11.1% (EMD recorded but not patient recorded). The reminders and motivational messages were found to be useful in 50% of patients only, however this study was limited in length (14-21 days) and the patient cohort reported high levels of adherence prior to the study(44).