Whistle training aid and smartphone App. provide objective data

Mark Sanders1 & Elizabeth Crawford2

1Clement Clarke International Limited, Edinburgh Way, Harlow, Essex,
CM20 2TT, United Kingdom

2Clin-e-cal Limited, Greenheys Business Centre, Pencroft Way, Manchester, M15 6JJ, United Kingdom

Background Inhaler technique instruction is particularly important as evidenced through requirements in international and national treatment guidelines. A plethora of training aids is available but there are few truly objective feedback tools. The Flo-Toneâ R device has been developed to guide Respimatâ inhaler users toward a longer duration of inhalation by producing an audible signal throughout the inhalation, and it is now possible to provide objective feedback of this manoeuvre through the associated use of a wirelessly-connected smartphone App.

Methods Two healthy-volunteer studies have been undertaken: the first where subjects (n = 25) were permitted to view the App.-display and a second where subjects (n = 14) were not. All volunteers completed three inhalation manoeuvres (Efforts).

Results During Effort-1 13 study-1 volunteers (52 % success) were able to achieve actuation in the first second of inhalation (mean 0.65 s) compared with 12 study-2 volunteers (86 %, 0.54 s) but once practice had occurred, the Effort-3 times to actuation were the same (0.37 – 0.38 s). A ≥ 2.0 second inhalation duration was more successfully achieved for both study groups, with study-1 subjects showing a > 20 % improvement in duration for Effort 3 (n = 20, 2.78 to 3.37 s), but with no similar improvement in study-2 subjects who lacked visual feedback (n = 14, 2.91 to 2.84 s).

Conclusions These initial studies suggest that repeated practice with feedback via visual display could improve duration of inhalation. The prospect of remote inhaler technique assessment and healthcare professional training using smartphone Apps. that deliver objective data is a step forward in e-health for respiratory patients.