Smart revolution? Designing the future of respiratory devices | Innovation

Miles Hawley, chief design officer at Precipice Design, writes why the next generation of respiratory devices is important if patients and clinicians want to see better outcomes.

This month will see respiratory specialists from across the globe descend on Paris for the 2018 edition of the European Respiratory Society's (ERS) International Congress. The Paris Expo Porte de Versailles is set to play host to more than 20,000 people from Europe and beyond in a bid to usher in a new era of enhanced respiratory medicine and technology. For innovators in pharma the conference offers a tantalising glimpse of the future of respiratory device design.

The challenges facing clinicians in empowering patients to better manage conditions such as asthma and Chronic Obstructive Pulmonary Disease (COPD) are huge. Worldwide, approximately 235 million people have asthma[i] while more than 3 million deaths are caused by COPD each year.[ii] In May 2014 the first ever National Review of Asthma Deaths revealed that two thirds of fatalities in the UK could be prevented with better routine care.[iii]

A wealth of compelling evidence highlights the negative patient outcomes associated with poor inhaler technique. Improper asthma inhaler device use is most likely one of the major causes associated with uncontrolled asthma and frequent admissions into emergency care.[iv] An inadequate inhaler technique will lower deposition to the lungs, waste medication and may lead to poor disease control, reduced quality of life, increased emergency hospital admissions and higher treatment costs.[v]

It is unsurprising that patients fail to use their inhaler correctly given that clinicians' understanding of correct device technique is often poor. A recent study highlighted that just 7% of healthcare professionals could demonstrate all the correct steps for a metered dose inhaler.[vi] With chronically low levels of inhaler compliance across the board, there is a clear and pressing need to ensure the inhalers of the future are more intuitive and responsive to the challenges faced by users as they attempt to manage their condition.

The emergence of the first generation of smart inhalers represents a hugely development in this field. Smart inhalers make use of Bluetooth technology to monitor inhaler usage, gather data to help clinicians plan future care, and remind patients when to take their next dose. Smart inhalers typically encompass monitoring devices that can be clipped to the user's existing inhaler. These devices accurately record the time each dose is taken and provide the patient with real time data via their smart phone.

Smart inhalers have been associated with improved patient outcomes in several studies, yet there remains massive room for improvement in fundamental areas.

In 2016 a study in the British Medical Journal shed new light on the challenges facing designers in the smart inhaler market. A study of 31 stakeholders including clinicians and members of clinical commissioning groups highlighted concerns about the clip-on nature of smart inhalers.[vii] The study found that patients have reported concerns that attaching monitoring devices to existing equipment could make the whole inhaler bulky and cumbersome to the point of discouraging use. Other concerns were raised about poor interface usability, with worries expressed that smart inhalers could mean that clinicians and patients are subjected to an overload of data.  

Going forward into the next decade designers must better understand how patients' perceptions of their condition are changing, developing devices that mean more to users as they seek to alleviate symptoms.  The asthma and COPD patients of the future will demand visually relevant, fully-integrated inhalers where electronics are embedded at the heart of the device rather than being included as an auxiliary add-on. The next generation of smart inhalers will deliver vastly improved patient usability, ensuring patients of all ages are empowered to manage their condition better.

Smart technology represents a golden opportunity in respiratory care into the 2020s and beyond. With the global smart inhaler market set to be worth more than $1.6 billion by 2022, it's clear those designers that drive genuine in the sector are set to be richly rewarded. But for designers like myself the richest reward of all is knowing that the work we are doing is making a palpable difference to people's lives.








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