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Aseptika

On the first day of Med-Tech Innovation Expo 2024, Aseptika launched the PUFFClicker3, its universal smart inhaler dose tracker, a world first, with an inhaler dose tracker that is compatible with both pressurised metered dose inhalers (pMDI) and dry powder inhalers (DPI). The PUFFClicker3 supports 101 SNOMED-coded inhalers for both pMDI and DPIs, making the switching to a new type of inhaler a simple process.

It provides in-built graphical instructions on how to use each inhaler it supports. The PUFFClicker3 smart inhaler was developed to improve inhaler adherence, for patients of all ages and for all respiratory conditions that require treatment with the use of inhalers.

Adherence to inhaler medications prescribed for chronic respiratory conditions is widely acknowledged to be poor, with an estimated half of patients not following their medication regimen as directe. Studies suggest that approximately 75% adherence to inhaled medication is necessary to control symptoms and reduce the risk of exacerbations. Inhaler adherence poses the primary challenge in managing respiratory conditions across all age groups, from children and young people (CYP) aged 6-18 years with poorly controlled asthma to adults with COPD, asthma and other respiratory ailments.

There exists a direct correlation between medication adherence and improved outcomes, emphasising the critical importance of consistently taking inhaler medication as prescribed, particularly in preventing further asthma attacks in children and young people, COPD exacerbations, Cystic Fibrosis and other respiratory conditions.

Overcoming several technical challenges shaped the development of the PUFFClicker3. One significant obstacle was the difficulty patients encountered when pairing devices via Bluetooth to a Smartphone. To address this, the company removed the necessity for smartphones to transmit data from the device to healthcare staff and parents/carers. Another factor influencing the design is the increasing number of schools banning smartphones for younger children.

Consequently, the PUFFClicker3 will employ mobile IoT technology to transmit data, enabling parents and carers to receive real-time updates. This feature will alert them when their child or young person is over-using reliever inhalers, whether at school or away from home.

The development of the PUFFClicker3 received backing initially from an Innovate UK Smart Award, facilitating the elimination of smartphone dependency whilst providing patients, parents, carers and healthcare professionals with the advantage of real-time inhaler adherence monitoring data.

As important is how the PUFFClicker3 reduces health inequities. Its interactive touch screen can show instructions in 16 languages. Removing the need for connection with a smartphone, supporting patients who are digitally hesitant.

The PUFFClicker3 universal inhaler dose counter includes:

• Compatibility with 101 SNOMED-coded pressurised metered dose (pMDI) and dry powder inhalers (DPI), offering a Universal Inhaler Dose Counter.
• User-friendly design with its own touch screen for ease of operation.
• Incorporation of simple animated graphics and sounds, providing guidance on how to use different types of pMDI and DPI inhalers, as well as the PUFFClicker3 device itself.
• Inclusive design with support for 16 languages (Arabic, Bengali, Czech, English, Gujarati, Hindi, Italian, Latvian, Lithuanian, Polish, Punjabi, Romanian, Russian, Spanish, Ukrainian, and Urdu), aimed at addressing health inequities stemming from language barriers. This aligns with the NHS Core20PLUS initiative, which targets patients who can find it sometimes difficult to access healthcare.
• Elimination of the need for a smartphone to transmit inhaler medication adherence data to the Cloud, enabling direct communication with parents, carers and healthcare staff. Additionally, the device stores data locally, providing patients with feedback on doses taken, upcoming dosage schedules and remaining doses in the inhaler.

Aseptika is now testing PUFFClicker3 with children and young people (aged 6-18) who have poorly controlled asthma. The aim is to gather their feedback on the usability and functionality of the device and assess how it could aid in managing their asthma, especially as they are transition to adult care.

This Patient and Public Involvement and Engagement (PPIE) initiative is backed by funding from SBRI Healthcare Phase I, aimed at enhancing the health and wellbeing of children and young people. So What? Consultancy Ltd is assisting with the PPIE and usability activities in collaboration with Health Innovation East (HIE) and with Health Innovation West Midlands (HIWM).

As part of this initiative, Aseptika is engaging with Asthma Nurses, GPs and Pharmacists to explore future pathways for introducing inhaler adherence through a straightforward 30-day implementation process, initially focusing on children and young people with poorly controlled asthma. The goal is to prompt behaviour change by providing a PUFFClicker3 device alongside inhalers, enabling data transmission for healthcare review by their healthcare professional during asthma assessments.

Insights from the Cochrane Review (2022) support the efficacy of digital interventions in improving adherence to maintenance medication in asthma, highlighting those patients provided with digital technology experience better asthma control and a reduced risk of asthma attacks, leading to tangible benefits in minimising asthma-related deaths. These findings align with outcomes observed in our clinical trial and evaluations involving children and young people with asthma and their Parents or Carers.

Reducing inhaler medication wastage contributes to carbon savings and inhaler adherence smart solutions can decrease the need for NHS emergency hospitalisations. An admission to a hospital's A&E for an asthma attack results in a significant emission of 125 Kg CO₂ per day. In contrast, a pressurised metered dose inhaler (pMDI) is associated with carbon equivalents of only 0.17 Kg CO₂. In many respects, prevention proves superior to treatment.

Professor Will Carroll (Consultant Paediatrician from University Hospitals of the North Midlands) said: “The truth is, admitting when things haven't gone well is challenging for both parents and young people. PUFFClicker3 removes the rose-tinted view and provides us with objective evidence of whether people are doing what they need to stay well. This is especially important for children whose asthma control isn't as good as it should be.

"Inclusivity is really important in healthcare, yet we seem to have performed poorly over the last 30 to 40 years. We know that health outcomes, particularly for asthma, are worse for children whose parents' first language is not English. It's really important to ensure that any solution is accessible to everyone."

Aseptika welcomes visitors to its exhibition stand C37 at the Med-Tech Innovation Expo at the NEC on June 5-6, 2024, to experience the PUFFClicker3 universal inhaler dose tracker firsthand.