Our inhaler design

Now keeping all the stated above in mind we propose to come out with an inhaler that solves most of the difficulties and has the following features –

·         Wireless chip, through which patient can be connected to the doctor and loved one at all time, Everytime the patient is under an attack it would send a message to the doctor and  guardian that the patient has  used the inhaler.

•       Through the wireless chip the inhaler will be connected to the doctors computer so that he can get the   report and the intensity of the attack of the patient and by the time the patient comes to the hospital , he’l be already be prepared and that would save time.

·         The inhaler will be transparent so that the patient can see the number of doses left in the inhaler.

·         The medicine can come in apple, mint flavors, so that they are easy to take, because otherwise these medicine leave the mouth of patient dry and bitter. (especially for children at school it will become easier).

Current cost of an inhaler -Rs135
The innovation would add up to the cost by Rs40
(30 for the wireless chip  and 10 for the flavored medicine)

It is just a small effort from our side to relieve the misery of the people and children suffering from this ailment and make it a little less painful.

Rendezvous with people having breathing disorders

So therefore we plunge deeper into the problem, we tried to understand it from a couple of more people suffering from breathing ailments:

We asked them the subsequent questions:

       How long have you suffered from breathing disorders?

·         Since birth

·         5yrs-10yrs

·         10 yrs – above

2.      What triggers your attack?

·         Pollution

·         Stress

·         Change of weather

·         Common cold/Flu

3.      What kind of inhaler/puffer do you use?

·         Metered dose inhaler

·         Bronchodilator

·         Nebulizer

4.      Have you ever come across a situation where you are under an attack and you are left with an empty inhaler, as you did not come to know when the medicine got over?

·         Yes

·         No

5.      Does you asthma medicine leave your mouth dry and bitter, would you prefer flavored medicine?

·         Yes

·         No

6.      Would like to stay connected with your doctor, regarding to go to his updates on change of medicine or dosage without having to go to his clinic every time.

·         Yes

·         No

7.      Are you satisfied with your medicine or puffer?

·         Extremely satisfied

·         Just about satisfied

·         Not at all satisfied

8.      How does it feel when you’re under an attack?

9.      Would you like to try out a redesigned inhaler?

Yes

No

 Patient - male age- 57 yrs

“ For me, i get two different feelings. One is the pain i get in my chest. It feels like something is squashing my lungs and it really hurts and only feels better if i can get air in. The other thing is the inability to get air into my lungs. I feel like there is almost something stuck in throat stopping me from getting air in and like my lungs are being compressed. You struggle really hard to get air in and it really tires you out because you are trying to force air into your lungs and only a little of it will go in. I have sports induced asthma and that really is appalling because it makes it hard for me to exercise hard. I also get asthma from changes in temp (as in walking from outside where it is hot into an air conditioned room) when i am sick with a cold or when i eat something im alergic to such as the mould in blue vein cheese. Lol so i really dont have a fun time, but i manage, have been doing it for years”

After the survey we found out the following

Q1

 54% - Since birth

33% - 5yrs-10yrs

13% - 10yrs+

Q2

 Here 

1 : Pollution

2 : Stress

3 : Change of weather

4 : Common cold/flu

5 : Others

  Q3

Metered dose inhaler - 73%

Bronchodilator - 7 %

Nebulizer - 20%

 

Q4

 Empty inhaler situation - yes (1)

Empty inhaler situation - No (2) 

Q5

Flavored medicine - Yes (1)

Non Flavored Medicine - No (2)

Q6

Stay connected- yes (1)

Not connected - No(2)

Q7

40%- extremely satisfied

33%-Just about satisfied

27%-Not at all satisfied

Q9

Current inhaler - No (1)

Redesign inhaler - Yes(2)

Most of the patients had the same experience

Currently the most commonly used inhaler is the metered dose inhaler

The difficulty faced by most people as told my patients and Doctor who treats them:

Ø  Patient does not know how or when to clean spacer
Ø  Patient cannot take inhalers properly because of poor device technique (across the continuum)
Ø  Patient does not know how to detect when MDI canister is empty
Ø  Patient cannot detect when Pulmicort, Oxeze or Bricanlyl Turbuhalers are empty because of lack of education or cognition around correctly detecting product emptiness
Ø  Patient not aware that they have 0 refills remaining and must see the doctor
Ø  Patient physically unable to go to doctor’s office to get inhaler prescription refills
Ø  Patient has several MDIs of each type in use unable to dose count as a result
Ø  Patient cannot physically clean spacer due to physical limitations
Ø  Patient chooses not to use spacer
Ø  Patient cannot afford medications and rations or stops them
Ø  Patient cannot take MDIs properlydue to physical disability
Ø  Polypharmacy
Ø  Cultural and literacy issues
Ø  Patient taking or being given empty or outdated MDI’s
Ø  Follow-up for inhaler usage is neglected on patients who have difficulty administering their inhalers
Ø  Patient loses doses inhaled medicine schedules and medication instructions
Ø  Patients fires multiple puffs into spacer (across the continuum)

History of Asthma Inhaler

As a medical device used for the delivery of medication into the body via the airways, the inhaler (or puffer) is the most common method of administering asthma medication to patients suffering from this condition or its related symptoms. Although documented incidences of asthma date back to the 1600s, it was the invention of the pressurized metered-dose inhaler (MDI) that first made anti-asthma therapy a real possibility.

History 

The original asthma medications delivered by MDI were pressurized and aerosolized preparations of isoproterenol and epinephrine that had been dissolved in alcohol by freon propellants.

Metered-Dose Inhaler

 

Introduced in 1956, this device is pressurized, delivering a precise amount of asthma medication to the patient's lungs via inhalation.

Bronchodilator

  

Invented in 1957, this small, fast-acting MDI administers asthma treatments by delivering a short burst of aerosolized medication that, upon inhalation, allows for the quick dilation and relaxation of the bronchial airways. 

Nebulizer 

Introduced in the 1960s, this device assists those asthmatics who suffer from severe asthma attacks or who cannot inhale deeply. It delivers a continuous dose of vaporized medication that is steadily inhaled over a period of time. 

Size 

The asthma inhaler (bronchodilator MDI) has been utilized for delivering approximately 70 percent of all inhaled medications among the 15 largest countries alone, reaching sales numbers of almost 500 million each year. 

Evolution 

Modern asthma inhalers have used chlorofluorocarbon (CFC) propellants to deliver aerosolized medications; however, in the past decade manufacturers have replaced this propellant with hydrofluoroalkane (HFA), which is more environmentally friendly.

Asthma is a chronic lung disease characterized by:

• Airway obstruction that is reversible either spontaneously or with treatment
• Airway inflammation
• Increased airway responsiveness to a variety of stimuli
• Airway remodeling

Asthma is neither a contagious disease nor a psychological disease. Scientific studies show that bronchial (airway) inflammation is present in all asthmatics, even if they do not have symptoms. Not recognizing the severity of the asthma episode places you at higher risk because treatment is often delayed. Asthma is a chronic disease. People with chronic illnesses are more likely to have problems with depression and despair if they do not learn how to cope effectively. You are at higher risk if you have difficulty accepting your asthma and its treatment. Although asthma is not curable, it usually can be well-controlled.

Asthma types and Classifications:

Mild Intermittent Asthma

• Symptoms of cough, wheeze, chest tightness or difficulty breathing less than twice a week
• Flare-ups-brief, but intensity may vary
• Nighttime symptoms less than twice a month
• No symptoms between flare-ups
• Lung function test FEV1 equal to or above 80 percent of normal values
• Peak flow less than 20 percent variability AM-to-AM or AM-to-PM, day-to-day.

Mild Persistent Asthma

• Symptoms of cough, wheeze, chest tightness or difficulty breathing three to six times a week
• Flare-ups-may affect activity level
• Nighttime symptoms three to four times a month
• Lung function test FEV1 equal to or above 80 percent of normal values
• Peak flow less than 20 to 30 percent variability.

Moderate Persistent Asthma

• Symptoms of cough, wheeze, chest tightness or difficulty breathing daily
• Flare-ups-may affect activity level
• Nighttime symptoms 5 or more times a month
• Lung function test FEV1 above 60 percent but below 80 percent of normal values
• Peak flow more than 30 percent variability.

Severe Persistent Asthma

• Symptoms of cough, wheeze, chest tightness or difficulty breathing continual
• Nighttime symptoms frequently
• Lung function test FEV1 less than or equal to 60 percent of normal values
• Peak flow more than 30 percent variability.

The level of asthma severity will determine what types of medicine you will need to get your asthma under control.

Reinventing the lifesupport for asthmatic patients

Imagine if you were told to hold your breath for say 5 minutes, how would you feel?Your first question will be, are you mad? Why would I ever do it? Picture the plight of the person suffering with breathing disorders. Think about those who had this disorder since birth, how much would they have suffered. I know how it feels because i am a patient of a bronchial asthma, the first time when i got this attack i was in Dehradun attending a marriage, 15 years old, it was December and very cold, i can never forget that night, i was struggling to breathe, i couldn't, i just couldn't, i was turning blue, my lips, my nails were all blue, i was loosing color. I couldn't think it was like someone had put a pillow on my face. Every one was trying to warm me up but nothing was helping, I was loaded with blankets. I remember my father coming up with the bright idea of giving me a spoon of brandy. I know it sounds weird but you know people that were the only thing that helped me a little. Since that was the first time i had this problem i did not have any medicines. Little did i know that it was the beginning of an illness that will last me a life time and i will have to carry my medicines with me wherever i go, and by chance if i forget i'l go through an excruciating painful 1 or 2 hours till i get my medicine.

So I’m glad that i got an opportunity to be able to reinvent the instrument which gives me life every time i get those awful attacks.

So with my team members , I’d like to first give a little history of different kind of breathing problems.

“All that wheezes is not asthma”. As a matter of fact due to our ignorance we feel that anyone who has breathing issues is suffering with asthma, but this is not true there different kinds of breathing disorders, Lets first understand what is wheezing?

Wheezing, or high-pitched adventitious sounds superimposed on the normal sounds of breathing, occurs when air flows rapidly through narrowed bronchi. Clinically, it should be viewed as a nonspecific manifestation of airway obstruction. Asthma is its most common cause, especially when the wheezing is episodic and the patient is young.