Felt the dry burning feeling of a dose hitting your throat when instead it should be flying down into your lungs? Or sensed that your child inhaled much more last time than now, although it seemed they went about it in exactly the same way?
Even if you’re the type who dives straight for instructions, it’s hard to find answers in the small-print to crucial questions like: Exactly how hard should I breathe in? Does it matter how long I hold my breath? How will I know if my child got the right amount of medicine? And is there enough to last over our vacation?
These are key questions if you or your loved one is sick and needs to get better or at least manage their disease. And for the 65 million people worldwide who live with Chronic Obstructive Pulmonary Disease (COPD), (symptoms can include: mucousy cough, wheezing and chest tightness) consistently getting the right amount of medication into the right part of their respiratory system can make an enormous difference to how they feel and how fully they can live their lives.
Yet more than half of inhaler users make mistakes, ranging from angling mouthpieces the wrong way to inhaling too much or holding their breath too little. And it is estimated that as many as 60 percent of all COPD users do not stick to their prescribed therapy.
According to Edna Shattuck, COPD patient, respiratory specialist and advocate for the COPD Foundation: “Even if people are taught how to use the many different kinds of inhalers, they sometimes forget, make excuses and give up.” Sadly, Edna died late 2017 of COPD complications.
And it’s not just using the inhaler correctly that’s the problem. Often patients either miss a dose, or take too many, because they don’t remember when they took the last one. “I used to leave the cap off so that I would know I’d taken it,” Edna had explained about her struggles with the condition. But even that was not infallible.
“Sometimes the doorbell rings or the dog distracts me, and I’m left wondering whether I actually used the inhaler, or was about to.”
For doctors too, treating patients with COPD can be an inexact science. Patients not only vary in how well they stick to treatment plans, but also in how accurately they can describe how they’ve actually been using their inhalers. It’s hard to know whether it’s the medication that’s the problem or the way the patient is taking it.
But, as in many other branches of medicine, technology brings the potential to change things dramatically for the better. New ‘intelligent inhalers’, expected to be on the market by the end of the decade, are an exciting development in the treatment of COPD, which, as populations age, is currently on course to be the world’s third leading cause of death by 2030.
Leveraging innovative science and connected technologies, new, more user-friendly devices will, for example, help control the inspiratory flow rate, so that variations in breath power do not affect dosages. They’ll ‘pair’ with mobile apps providing real-time data for patients and doctors about device usage as well as long-term trends in breath profiles. They will also incorporate step by step on-screen instructions to help patients use their inhalers more effectively.
Steve Wick, technical director at 3M, explains that ‘intelligent’ inhalers should also make it easier for doctors to objectively assess how well a treatment is working so they can change the plan as quickly as possible if needed.
For people like Edna, for whom each breath became a struggle, the hope is that the devices will increase transparency and trust between patients and their doctors. “My doctor will be able to see that I took the medication correctly,” hoped Edna, “and I’ll be able to see that I am being the best possible patient I can be.”