Patient centered development of a new valved holding chamber (VHC) designed specifically for on-the-go use

Abstract

Background: Although VHCs have been shown to minimize problems of poor inhalation technique and target pMDI delivery to the lungs, they are often left at home due to their size and appearance. Method: As part of a new development project for a VHC intended primarily for use ‘on the go’, patients were actively involved in all steps of the process. These included a) understanding the patient needs and therefore problems to solve, b) interactive involvement in concept development, c) feedback on functionality and appearance, and d) handling / usability. Results: A survey of 715 asthma and COPD patients (14-77 years) indicated that only 13% always used a VHC with their pMDI. Portability, lack of clinician recommendation, and embarrassment were highlighted as key factors why not used. Collaborative exercises and generative design sessions were conducted with inhaler users. A critical learning was that patients preferred a 2-in-1 spacer and protective case for pMDI to smaller or collapsible spacers carried separate to the pMDI for use on-the-go. Prototypes were developed and handling studies performed to evaluate multiple device form factors. The final prototype was confirmed by patients as being highly desirable and very likely to use while on-the-go. Aerosol testing was also performed to verify acceptable drug delivery. Conclusions: The continuous involvement of patients resulted in a number of key insights that helped guide the design process, resulting in the development of a VHC that patients are much more likely to use while on-the-go.