Inhaler technique is the quiet failure of inhaled therapy. Most people don't use their inhaler correctly, so much of the dose never reaches the lungs, and because no one can see the mistake, no one fixes it. The question worth answering is whether putting technique back in view, for the patient and the pharmacist, actually changes how people inhale.
We presented an evaluation of exactly that at Respiratory Drug Delivery (RDD) 2026: a real-world, pharmacy-led connected-inhaler service across five pharmacies in the Netherlands. Seventy-two adults enrolled and 59 were analysed (those seen at least twice), with asthma (40) or COPD (19), over a median of about a month. Technique was measured at the first and last visit and compared with paired statistical tests. Crucially, it spanned three different inhalers: GSK's Ellipta, Chiesi's Nexthaler and Plastiape's RS01.
Over the service, the share of "good" inhalations rose by 15.65 points to 64.1% (p<0.0001), while poor inhalations fell (p=0.0002). In all, 73% of patients (43 of 59) improved their technique. Average adherence across the study was 82%.
The gains showed up in the specific things that go wrong: peak inspiratory flow (good inhalations +10.6 points, p=0.002), inhalation duration (+11.8 points, p=0.0001) and holding the inhaler the right way up (+10.2 points, p=0.0006). Variability narrowed too, so patients weren't just better on average, they were more consistent.
The population that matters, across the devices that matter
What makes this result useful is who it's in and where it's set: adults living with asthma and COPD, in routine pharmacy care, not healthy volunteers in a laboratory. And because it held across three unrelated inhalers, including the RS01 behind RS01X, the improvement tracks with Respiro being present rather than with any one device. Technique improved wherever the data was visible.
"Technique is the part of inhaled therapy everyone knows is broken and no one can see. Make it visible, in a real pharmacy, with the inhalers patients actually use, and it moves."
Martijn Grinovero, Chief Commercial Officer, Amiko
This is a real-world service evaluation, not a controlled trial: improvement was measured within each patient over time rather than against a comparison group, the follow-up is short, and the figures describe a study population, not any individual's result. Read alongside the controlled ERS 2022 trial, it adds the breadth, and the full evidence base sits on our evidence page.
Source: Borst J, Franza M, Citterio M, Cova C, Ponti L, Grinovero M. Improvement in Inhalation Technique During a Pharmacy-Led Connected Inhaler Service Evaluation in Adults with Asthma or COPD. Respiratory Drug Delivery (RDD) 2026, poster. Real-world, single-arm pre-post evaluation; 72 enrolled, 59 analysed; median follow-up ~1 month; industry-affiliated authors. Adherence (82%) is an attained rate over the study, not a within-study change. Describes a study population, not a promise of individual results.