Being a device user and a trained designer, brings a unique perspective to medical device development. This week, Design Director, Mark, shares insight into his experience of using inhalation devices as well as what his ideal inhaler would feature:
For the past few years I’ve been using the Teva DuoResp Spiromax, which is a breath actuated dry powder inhaler (DPI) and contains 2 active substances; budesonide and formoterol fumarate dihydrate.
Firstly, for me, the drug combination has had a massive impact on the treatment of my asthma. A real game changer in eliminating the day-to-day wheeziness and breathlessness that I experienced all my life while using other inhalers. As well as the over-all effectiveness, the two drugs together mean that the one inhaler can be used as a preventative and a reliever, instead of using two separate inhalers.
Putting the drugs aside, the usability of the DuoResp Spiromax is also great for lots of reasons including;
Over the last 40 years, I’ve used many different inhalers and there are things I’d definitely change about them:
My very first preventative inhaler was a SpinHaler which was an assembly of 3 parts, plus a dry powder capsule (shown in the below image – one of my original ones from the 80’s!). To use the inhaler, the user would have to disassemble the device, remove the used capsule, load in a new one, reassemble, then pull a sleeve up and down to pierce the capsule. The inhaler itself had a plastic cylindrical case and the capsules were held loose in a separate plastic bottle. As a child, I hated taking this inhaler so much as it left powder and often pieces of the pierced capsule in my mouth!
Before moving on to the long-acting reliever type of inhalers, I carried a Ventolin/salbutamol pMDI with me everywhere I went. The angular shape of the inhaler used to leave an inhaler shape worn into the left thigh of every pair of jeans I owned!
Although the mouthpiece is nicely covered, the classic design of a pMDI, such as a Ventolin inhaler, has an open top where the canister is inserted. I always used to get frustrated with the amount of pocket dust, hair and sweet wrappers that used to find its way into the inhaler and into my mouth. This led me to carrying my inhaler in a sandwich bag! I found that pMDI inhalers, particularly relievers, lose effectiveness throughout the life of the device, whereas a DPI seems to retain the same effectiveness until it is completely empty. If I was to pick faults with my current DPI inhaler, it can be quite noisy to use compared with a pMDI. A final frustration is that inhalers can be very medical looking and in a lot of cases, the shape and appearance of pMDI’s hasn’t changed in the last 40-50 years. |
I may have used a trainer device during an asthma review at the doctors years ago but in my experience, they usually ask patients to bring their own inhaler with them to check how good their technique is. Peak flow meters are also used in asthma reviews to monitor how well a patient can push air out of their lungs.
I have never used a smart inhaler but would be interested in trying one to see what benefits it can offer. The only information I need from the device is how many actuations are left but it would be handy if it could connect to the pharmacy app on my phone and order a new one when it’s running out.
Dry powder inhalers are much more sustainable than pressurised metered dose inhalers due to the aerosol canisters used in pMDIs, so I am less concerned now that I only use a DPI. However, some of the packaging and instructions-for-use booklets are a little excessive. There is definitely a lot that could be done to make inhalation devices more sustainable.
Bringing together some of the points mentioned above, my ideal inhaler would be: –
Here at HD we have a wealth of experience in inhalation devices, whether that be knowledge gained from design, or from actual use. Having insight from real world users, such as our Design Director Mark, allows us to develop designs that are dealing with problems and frustrations faced by users day-to-day.