Drug delivery
this is obviously more challenging.” Designing an inhaler device that patients clearly understand how to use just by looking at it is very difficult to achieve, due to the natural complexity involved in pulmonary drug delivery. “If companies first reach out to patients to gain knowledge on their perspectives, perceptions, and critical usability needs, the chances of developing a prototype that is more intuitive to the patient’s eye will increase exponentially,” Drumond says.
Combining digital apps and inhalers with sensors embedded in them could be an important frontier in patient-centric product design.
they perceive the drug product? How do they intend to use it? And how appropriate is the design being proposed? Generating this knowledge early into the development process will likely increase the chances of commercialising a highly effective drug therapy with strong patient acceptability and compliance.” So, what are the physical attributes that matter when designing such a product? Drumond says usability factors, such as inhaler size and available grip, must be taken into account during the design process, and that considerations should also be made for patients with visual acuity problems, who may not be able to read dose indicators or instructions for use. Other factors are related to complexity of use, employing a correct administration technique and a patient’s individual capacity to fully inhale the required dose. Device intuitiveness, he adds, is often a “huge limitation” in product design.
“When designing an inhalation device, you need to make sure the required administration technique becomes intuitive for the patient,” says Drumond. “Unfortunately, the majority of devices available on the market do not provide that. If you give a tablet to a patient, the patient understands they will need to swallow it – it is very intuitive. For inhalation devices,
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Smart technologies There’s one key technological development that could be instrumental in the design of more patient- friendly inhalation devices, and it follows a trend seen elsewhere in drug delivery. “Smart inhalers are devices with in-built sensors that can be linked to your smartphone via digital technology, and not only provide valuable information on the accuracy of your inhalation technique and your total inspiratory flow, but also remind you to take your dose on time and alert you if you are missing or repeating a dose,” says Drumond. “I understand that for older patients, this technology might become more difficult to navigate, but I still think having access to it is a game-changer, because patients are given the opportunity to educate themselves from the information being received on their smartphone. Simultaneously, they rely less on their healthcare provider and will reduce the burden on healthcare systems.” It’s hard to argue with any technological development that takes the pressure off healthcare systems, and smart drug delivery is a concept already explored for the management of long-term conditions like diabetes. But the evidence supporting a beneficial impact on patients is scarce. One recent paper titled ‘The effectiveness of digital health technologies for patients with diabetes mellitus: A systematic review’, concluded after examining outcomes from a total of 3,360 participants across 25 randomised controlled trials, that digital health interventions for those with diabetes mellitus can improve glycaemic control, but there was no consistent clinical impact identified due to a wide variety of options on the market. There’s also the question of cost, which Forbes identified as a barrier even without the inclusion of sensor technology. Given the cost barrier, along with the research and development hurdles that must be overcome to bring inhalable drug delivery devices to market, Forbes expects to see a trickle rather than a flood of such products hitting the market in the near future. “I think there will be an increase of the more expensive biologic drugs which are getting closer to the market,” he says. “It is the cost of development as much as anything else. Inhalables are a complex drug development route compared to oral development, which is much more straightforward and much better understood.” ●
World Pharmaceutical Frontiers /
www.worldpharmaceuticals.net
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www.shutterstock.com
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