‘Whistle’ to help you use your inhaler properly

ASMALL ring that clips on to an i nhaler and whistles when patients use it correctly could slash the number of potentially fatal asthma attacks. The Clip-Tone device detects the speed and force with which patients are inhaling, and if this is sufficient enough to get the medicine into their lungs, it whistles.

If it does not whistle, it means the entire dose is not reaching the airway, increasing the risk of a flare-up. The idea is to teach patients to use their inhalers correctly to avoid this.

In a recent study, patients who used Clip-Tone consistently inhaled for the proper amount of time. The device has now launched in Britain (not Ireland as yet).

Ireland has one of the highest incidences of asthma in the world— and there is one death per week in this country from the disease, many as a result of poorly controlled illness, which means they are not getting enough steroid drugs into their lungs to prevent an attack.

It’s estimated that up to one in three patients is making their condition worse by not using their inhalers properly, meaning their medicine is deposited on the tongue, or at the back of the throat, instead of reaching the lungs.

Asthma patients use inhalers mainly to take steroids such as beclomethasone (which dampens down inflammation in the lungs), or salbutamol (to clear the airway when they become wheezy).

They are known as metered-dose inhalers as each squeeze of the canister releases a precise dose. This varies according to the severity of the patient’s asthma.

But to get the medicine into the lungs, the patient must inhale deeply for five seconds at the exact moment they press the canister. It’s a technique that many struggle to master, especially children.

Spacers — plastic chambers that hold the aerosol until the patient is ready to breathe it in — can improve uptake, but they are bulky and hard to carry around.

The Clip-Tone device could be a simple solution. The ring clips on to the top of the inhaler, and as the patient breathes in with the inhaler in their mouth, air moves through a tiny hole in the Clip-Tone.

This produces a whistling sound when the speed of the inhaled air reaches 20 litres a minute — the minimum rate needed to help propel the drug into the lungs. As soon as they hear the whistle, the patient presses the canister to release the drug. The patient continues to breathe in for five seconds.

The device can also be paired with an app which charts how well it’s being used.

A study published in the European Respiratory Journal in September showed that nearly twice as many patients correctly inhaled for five seconds when using Clip-Tone, compared to those just given verbal advice on how to improve their technique.

THE product only fits Evohaler pumps used, for example, for Ventolin and Seretide inhalers, which are common here. But the company behind it, Clement Clarke International, says it is working on other versions to fit differently shaped inhalers.

Eventually, it says, t he whistling device will be built into all inhalers at the time of manufacture.

Dr Mark Levy, a GP specialising in asthma says: ‘This is a simple but ingenious device. It stops asthma patients having life-threatening attacks and cuts down on healthcare waste.

‘Much of the steriod inhaler medicine just ends up in patients’ throats.’