How to make a standard inhaler device into a ‘smart’ inhaler
that teaches technique
Sanders MJ1, Bruin R1 & Tran CT2
1Clement Clarke International Limited, Edinburgh Way, Harlow,
Essex, CM20 2TT, UK
2i2c Pharma Services, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK
Background Asthma patients frequently use multiple inhalers: internal resistances will vary, with different inspiratory flow rates (IFR) required to deliver drug therapy. These ‘simple’ devices are frequently misunderstood, particularly when pressurised metered dose (pMDI) and dry powder inhalers (DPIs) are used concomitantly.
Methods We have developed a low cost, resistance-specific, ridged amendment to existing inhaler actuator geometry that provides a whistle-sound specific to the IFR that equates to correct use.
Results Using a pMDI ridged actuator and a capsule DPI with variable ridged sections attached to one/both air inlets, proof of concept produced audible signals detectable by a smartphone spectrum analyser App. and imaged, precisely, inhaler flow rate. Next Generation Impactor comparisons of standard and ridged actuator Atroventâ 20 µg ipratropium bromide (IB) pMDIs, and of Flutiform® Landmark® 5 mg formoterol fumarate (FF)/125 mg fluticasone propionate (FP) pMDI actuator and two types of retro-fit actuator ridging demonstrated co-deposition particle size distributions and no effect on aerosol characteristics. Fine particle fractions (FPF, % < 5.0 µm) for IB standard and ridged actuators were 41.0 ± 2.4 and 41.4 ± 2.1, and fine particle dose data (FPD, µg < 5.0 µm) 6.1 ± 0.5 and 6.1 ± 0.2, respectively. Respective Landmark and retro-fit FPFs (FF: 41.8 ± 1.5, 37.8 ± 2.0; 39.0 ± 2.1; FP: 37.3 ± 1.0, 33.7 ± 1.9, 34.8 ± 1.7) and FPD data (FF: 1.6 ± 0.1, 1.4 ± 0.2, 1.5 ± 0.1; FP: 41.9 ± 1.1, 37.7 ± 2.9, 39.9 ± 2.0) were broadly comparable.
Conclusions The ridged actuator/insert enables quantitative and qualitative dose-logging via smartphone: a technology that a majority of people possess and enjoy using. This new device may replace current add-on audible training tools via incorporation at very low cost into all metered dose inhalers.