The inhalation manager: a new computer-based device to assess inhalation technique and drug delivery to the patient

Kamin WE, Genz T, Roeder S, Scheuch G, Cloes
R, Juenemann R, Trammer T.

J Aerosol Med. 2003 Spring;16(1):21-9.

Johannes Gutenberg University,
Mainz, Germany.

The rational choice of an inhalation device is a cornerstone in the
effective management of asthma and COPD. In this publication, we describe the
development of a new system, the Inhalation Manager, which, for the first time,
offers the possibility to assess the entire inhalation maneuver of patients
using original devices under everyday conditions. So far the Inhalation Manager
allows the measurement of inspiratory maneuvers of patients through placebo
inhalation devices of the most common breath-actuated CFC-free inhalers in the
market for the three main glucocorticosteroids Budesonide [Turbohaler (TH), dry
powder inhaler (DPI)], Beclomethasone dipropionate [Autohaler (AH), breath-actuated
pressurized metered dose inhaler (pMDI)], and Fluticasone propionate [Diskus
(DI), DPI] by means of a pneumotachometer. In addition, it allows allocation of
the individual maneuver to the expected drug delivery values (mass output and
particle size distribution) of these three devices. In a field trial, the
inhalation technique of 628 (TH), 794 (AH), and 795 (DI) patients,
respectively, was tested in 72 pulmonologist practices with the Inhalation
Manager. For patients in the 18-59-year-old group, the Inhalation Manager
detected the following percentages needing improvement: 1.5% for the Autohaler
device, 16.7% for the Diskus, and 38.9% for the Turbohaler. In the
60-99-year-old group, percentages needing improvement were 1.5%, 31.5%, and
66.1% for the Autohaler, Diskus, and Turbohaler, respectively. Therefore, the
Inhalation Manager could become an essential tool in asthma management by
finding the most suitable inhaler for an individual patient and by training the
optimal inhalation technique.