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Self-reporting by patients to clinicians about their inhaler use can be complicated and is known to some- times be erroneous. 3 Connectivity can enable accurate reporting of inhaler use. As Hippocrates said, "Keep a watch also on the faults of the patients, which often make them lie about the taking of things prescribed." Connectivity supports remote management, which may facilitate patient care with fewer office appoint- ments, emergency room visits and hospitalizations. It also allows tracking of patterns of use, for example, overuse of a rescue inhaler, which could indicate the need for a change in care. e most obvious and important benefit of connectiv- ity is providing assistance for patients, which may improve their adherence. In turn, increased adherence may foster better control of symptoms and promote faster remission of disease. This may result in fewer missed work days and improved work performance. It can also encourage patients to be more mobile and socially active, increasing their enjoyment of activities. It may also reduce their dependency on family and other caregivers and decrease personal and family stress. For healthcare providers Inhaler connectivity enables automated recordings of events. Data about the timing and frequency of such events and a patient's responses to dosing can assist providers in determining how best to treat disease in a particular patient. 4 Providers may also benefit from the ability to integrate information about medication dosing, patient history, peak flow, FEV 1 and other vital signs, as well as events and environmental conditions triggering exacerbations that patients or a connected inhaler may have reported. 5 is information may help guide provider decisions about treatment changes to improve outcomes. Connectivity can help practitioners assure patients of inhaler replenishment and plan changes in care proto- cols. Such capabilities can help providers create stronger professional bonds with patients and pharmacies. Data from connected inhalers can enable providers to prioritize patients who need more care and reduce face- to-face interactions with patients whose conditions are well controlled. In addition, algorithms that offer assis- tance, especially to non-compliant patients, may assist providers in improving care for such patients and may assist in decreasing overall healthcare costs. For critical events, connectivity can offer near real-time intervention, which may lessen patient emergency room visits and hospitalizations. Decreased needs for such added care may help reduce overall costs and improve provider ratings such as the Medicare Overall Star Rating. 6 For pharmacies and pharmaceutical manufacturers Connectivity and automated identity of pharmaceutical devices, such as the serialized prescription labeling now required in the United States, 7 can facilitate tracking of Inhalation OctOber 2018 11

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