Summary
Inhaler technique is critical for pulmonary drug delivery. Poor inhaler technique is common among patients and consumes substantial health system resources in training, yet retention rates of good technique are low. In particular, the inhalation flow rate and duration taken to inhale a pressurised metered dose (pMDI) can lead to inconsistency in delivered dose. It is known that a slow inhalation results in superior drug deposition in the lung. We investigated whether a multi-sensory inhaler technique system could improve technique and retention. The group comparative study followed 59 pMDI treated asthma patients using an audible acoustic flow rate signal (Clip-ToneTM, Clement Clarke) and a visual, real-time, feedback smartphone application (Clip-Tone BuddyTM, Clin-e-cal) over a period of six months and compared them to a control group (58) of patients receiving usual care. The audio-visual enabled intervention group had a highly significant increase in inhalation duration (p<0.001) and a significant improvement in inhaler technique (p<0.001). This improvement was retained throughout the study period.
This study indicates that the use of an acoustic flow rate guidance signal coupled with a real-time feedback smartphone application may be a useful approach, not only for initial training but also for ongoing daily medication, to achieving improved technique and slower inhalations with pMDI devices, and thus improving the usability of inhaler devices.