Table 3 Identified barriers and facilitators summarised by theme.
Theme 1: Perceived benefits | |
F | Availability of functionalities (PT, HCP, D) |
F | Patients being motivated to use smart inhalers (HCP) |
B | Regular confrontation with disease for patients (HCP) |
B | Alternative options to improve asthma care available (PM) |
B | Patient characteristics: well-controlled asthma (PT, D), lack of need for change (PT), higher age (PT, PM) |
F | Use of smart inhalers supported by HCP (PT) |
F | Evidence on improved clinical outcomes (HCP) |
F | Smart inhalers implemented in guidelines (HCP) |
F | Evidence of benefits for individual health, population health and cost reduction (PM) |
F | Evidence on which subgroup(s) would benefit (PM) |
F | Start-stop criteria (PM) |
F | Evidence on feasibility of implementation (PM) |
Theme 2: Usability | |
2.1. User-friendliness | |
F | Inhaling is as easy as without smart inhaler (PT, HCP) |
F | Limited frequency of push messages, no pedantic character (PT, HCP) |
F | Intuitive installation and use, not requiring much effort (PT, HCP, D) |
F | Easy to prescribe (HCP) |
F | Passive data collection, little effort for patients and HCPs (PT, HCP, D) |
F | Possibility to personalise the app (PT, HCP, D) |
F | Involvement of all stakeholders in development process (D) |
2.2. Compatibility | |
B | Lack of compatibility on different levels (PT, HCP, PM, D) |
2.3. Education and support | |
F | Ability to choose the form of support (when setting up and using smart inhalers) (HCP) |
F | Possibility to contact HCP in case of problems with smart inhaler (PT) |
F | Clear protocol and one responsible person within organisation in case of problems (HCP) |
F | Trained team at HCP level (HCP, D) |
F | Helpdesk, troubleshooting material and intuitive instructions in app (D) |
Theme 3: Feasibility | |
F | Minimal time investment and fit in daily routines (PT) |
B | Limited consultation time (HCP) |
F | Small target group (HCP) |
B | Lack of environmental sustainability of smart inhalers (HCP, PM) |
F | Agenda setting (HCP, PM, D) |
F | (National) platform for smart inhalers provided by policy makers (D) |
B | (Dutch) legislation regarding promotion of medication/medical devices (HCP, D) |
F | Healthcare organisations need to be willing to change workflows (PM) |
B | Development of smart inhalers evolves more slowly than expected (D) |
Theme 4: Payment and reimbursement | |
B | Lack of reimbursement (PT, HCP) |
F | Clearly defined target group to minimise costs (PM) |
B | Current financial incentive in (Dutch) health care system(s) (i.e. production could decline due to innovation) (PM) |
B | Difficult to decide which technologies should be reimbursed due to rapid evolvement of technologies (PM) |
F | Reimbursement of invested time for HCPs (D) |
Theme 5: Data safety and ownership | |
F | Knowledge on who has access to data (PT) |
F | Proper data security (PT) |
B | Commercial interest (PT, PM) |
B | Uncertainty on who has access to data and on what developers will use data for (PM) |
F | Providing clear information to patients on data storage (where, purpose, who has access) (D) |
F | Data sharing (PT, HCP) |
B | Data sharing (PT, HCP) |
