Research presented at the Respiratory Drug Delivery (RDD) 2021 conference suggests that inhalers using acoustic technology developed in the UK could provide a viable alternative to expensive electronic smart inhalers for the millions of respiratory disease patients with poor inhaler technique. The acoustic technology is either attached or integrated into the inhaler device, and works in tandem with a smartphone application which detects the acoustic signal and provides real-time feedback and guidance on correct inhaler technique.
Up to 90% of asthma and COPD patients have been reported to demonstrate incorrect inhaler technique in clinical studies. Training has been shown to have a short-term effect on inhaler technique, but the majority of patients quickly return to their previous technique.
Improved inhaler technique is associated better asthma control, which should lead to fewer respiratory distress episodes, reduced medication use, leading to fewer side effects, and fewer hospital admissions. The European Respiratory Society has also highlighted correct inhaler technique as one of the key ways to promote a green and sustainable approach to asthma care, as it ensures that patients use their medication as effectively as possible.
Lead authors of the research, Mark Sanders, Chief Technology Officer at Clement Clarke International, and Dr Elizabeth Crawford, CEO of Clin-e-cal, commented, “We believe that our acoustic technology is a major development towards making low-cost, smart inhalers capable of improving inhaler technique and respiratory disease management widely available. This technology really is a viable alternative to the expensive Bluetooth smart inhalers, which to date have failed to penetrate the mass market.”
Independent research was also presented at RDD 2021 from a team of researchers from Beni-Suef University, Egypt, which evaluated the effect of inhalers using acoustic technology in combination with a smartphone app on inhaler technique. The study had 200 adult participants with asthma, who were split into two groups. The ‘verbal’ group received only verbal counselling on their inhaler technique, while the ‘advanced’ group received verbal counselling as well as using the Clip-Tone inhaler attachment with the Clip-Tone Buddy smartphone app.
The study found that the “use of training devices with smartphone application together with traditional verbal counselling for teaching asthmatic adults […] the correct steps of MDI inhalation technique resulted in significant improvement in pulmonary function and a significant reduction in the number of inhalation technique mistakes, compared to using traditional verbal counselling only.”
Both the Clip-Tone inhaler attachment, and the In-Tone actuator, which is integrated into the inhaler, have been developed by leading UK medical technology manufacturer Clement Clarke International. Both devices use the same technology to create an acoustic signal when the inhaler is used correctly. The companion smartphone app, Clip-Tone Buddy (from Clin-e-cal), detects the acoustic signal and provides visual feedback and tips to the inhaler user, as well as keeping a record of inhaler use which can be shared with the user’s clinical team.
The Clip-Tone device is compatible with a wide range of inhalers, and is currently available to patients in the UK via prescription. The Clip-Tone Buddy app is currently available to download for free from the Apple and Google Play app stores.
