Objective Assessment of Patient Inhaler User Technique Using an Audio-Based Classification Approach.
Many patients make critical user technique errors when using pressurised metered dose inhalers (pMDIs) which reduce the clinical efficacy of respiratory medication. Such critical errors include poor actuation coordination (poor timing of medication release during inhalation) and inhaling too fast (peak inspiratory flow rate over 90 L/min). Here, we present a novel audio-based method that objectively assesses patient pMDI user technique. The Inhaler Compliance Assessment device was employed to record inhaler audio signals from 62 respiratory patients as they used a pMDI with an In-Check Flo-Tone device attached to the inhaler mouthpiece. Using a quadratic discriminant analysis approach, the audio-based method generated a total frame-by-frame accuracy of 88.2% in classifying sound events (actuation, inhalation and exhalation). The audio-based method estimated the peak inspiratory flow rate and volume of inhalations with an accuracy of 88.2% and 83.94% respectively. It was detected that 89% of patients made at least one critical user technique error even after tuition from an expert clinical reviewer. This method provides a more clinically accurate assessment of patient inhaler user technique than standard checklist methods.
Funding
Enterprise Ireland Innovation Partnership (2015/0412/B). Irish Research Council (IRC) Enterprise Partnership Scheme (EPS), Vitalograph Ireland (Ltd.) Health Research Board (HRB) Clinician Scientist Award (CSA/59)
History
Comments
The original article is available at www.nature.comPublished Citation
Taylor TE, Zigel Y, Egan C, Hughes F, Costello RW, Reilly RB. Objective Assessment of Patient Inhaler User Technique Using an Audio-Based Classification Approach. Scientific Reports. 2018;8(1):2164.Publication Date
2018-02-01External DOI
PubMed ID
29391489Department/Unit
- Beaumont Hospital
- Medicine