The global prevalence of asthma and chronic obstructive pulmonary disease (COPD) is on the order of hundreds of millions of individuals. The most common treatment approach is to take a self-administered inhaled medication. This study focuses on pressurized metered-dose inhalers (MDIs) where, unfortunately, rates of mishandling and misuse are extremely high and lead to improper treatment. One significant challenge results from the timing miscoordination of the medicine dispersion and inhalation breath. To address this, this study demonstrates the feasibility of automating the timing of the medicine dispersion by integrating a shape memory alloy (SMA) actuator and a differential pressure sensor into the casing of a traditional MDI. The approach is to measure the vacuum pressure created by an inspiratory breath, evaluate criteria indicating an acceptable breath, and if those criteria are met, heat the SMA actuator to depress the cartridge and disperse medicine. To meet actuation requirements and reliably depress the inhaler cartridge, two concepts for configuring an SMA wire were designed and compared with respect to complexity, actuation timing, and energy consumption. The proposed concept was able to disperse medicine in 263 ms, averaged over 100 actuations on a single battery charge, facilitating the early dispersion of medicine during an inhalation breath. By describing the design process of an SMA-actuated MDI that does not result in a significant increase of its weight or size, this study provides a practical technological approach for reducing the improper treatment of asthma and COPD due to timing miscoordination.

References

1.
Beasley
,
R.
,
Crane
,
J.
,
Lai
,
C. K.
, and
Pearce
,
N.
,
2000
, “
Prevalence and Etiology of Asthma
,”
J. Allergy Clin. Immunol.
,
105
(
2 Pt. 2
), pp.
S466
S472
.
2.
Buist
,
A. S.
,
McBurnie
,
M. A.
,
Vollmer
,
W. M.
,
Gillespie
,
S.
,
Burney
,
P.
,
Mannino
,
D. M.
,
Menezes
,
A. M.
,
Sullivan
,
S. D.
,
Lee
,
T. A.
,
Weiss
,
K. B.
,
Jensen
,
R. L.
,
Marks
,
G. B.
,
Gulsvik
,
A.
, and
Nizankowska-Mogilnicka
,
E.
,
2007
, “
International Variation in the Prevalence of COPD (the Bold Study): A Population-Based Prevalence Study
,”
Lancet
,
370
(
9589
), pp.
741
750
.
3.
Ding
,
B.
, and
Small
,
M.
,
2017
, “
Treatment Trends in Patients With Asthma–COPD Overlap Syndrome in a COPD Cohort: Findings From a Real-World Survey
,”
Int. J. Chronic Obstruct. Pulm. Dis.
,
12
, pp.
1753
1763
.
4.
Melani
,
A. S.
,
Bonavia
,
M.
,
Cilenti
,
V.
,
Cinti
,
C.
,
Lodi
,
M.
,
Martucci
,
P.
,
Serra
,
M.
,
Scichilone
,
N.
,
Sestini
,
P.
,
Aliani
,
M.
, and
Neri
,
M.
,
2011
, “
Inhaler Mishandling Remains Common in Real Life and Is Associated With Reduced Disease Control
,”
Respir. Med.
,
105
(
6
), pp.
930
938
.
5.
Melani
,
A. S.
,
Canessa
,
P.
,
Coloretti
,
I.
,
DeAngelis
,
G.
,
DeTullio
,
R.
,
Del Donno
,
M.
,
Giacobbe
,
R.
,
Scarlato
,
I.
,
Serafini
,
A.
,
Barbato
,
N.
,
Vaghi
,
A.
, and
Sestini
,
P.
,
2012
, “
Inhaler Mishandling Is Very Common in Patients With Chronic Airflow Obstruction and Long-Term Home Nebuliser Use
,”
Respir. Med.
,
106
(
5
), pp.
668
676
.
6.
Crompton
,
G. K.
,
Barnes
,
P. J.
,
Broeders
,
M.
,
Corrigan
,
C.
,
Corbetta
,
L.
,
Dekhuijzen
,
R.
,
Dubus
,
J. C.
,
Magnan
,
A.
,
Massone
,
F.
,
Sanchis
,
J.
,
Viejo
,
J. L.
, and
Voshaar
,
T.
,
2006
, “
The Need to Improve Inhalation Technique in europe: A Report From the Aerosol Drug Management Improvement Team
,”
Respir. Med.
,
100
(
9
), pp.
1479
1494
.
7.
Price
,
D.
,
Bosnic-Anticevich
,
S.
,
Briggs
,
A.
,
Chrystyn
,
H.
,
Rand
,
C.
,
Scheuch
,
G.
,
Bousquet
,
J.
, and
Inhaler Error Steering Committee
,
2013
, “
Inhaler Competence in Asthma: Common Errors, Barriers to Use and Recommended Solutions
,”
Respir. Med.
,
107
(
1
), pp.
37
46
.
8.
Lavorini
,
F.
,
Magnan
,
A.
,
Dubus
,
J. C.
,
Voshaar
,
T.
,
Corbetta
,
L.
,
Broeders
,
M.
,
Dekhuijzen
,
R.
,
Sanchis
,
J.
,
Viejo
,
J. L.
,
Barnes
,
P.
,
Corrigan
,
C.
,
Levy
,
M.
, and
Crompton
,
G. K.
,
2008
, “
Effect of Incorrect Use of Dry Powder Inhalers on Management of Patients With Asthma and COPD
,”
Respir. Med.
,
102
(
4
), pp.
593
604
.
9.
Restrepo
,
R. D.
,
Alvarez
,
M. T.
,
Wittnebel
,
L. D.
,
Sorenson
,
H.
,
Wettstein
,
R.
,
Vines
,
D. L.
,
Sikkema-Ortiz
,
J.
,
Gardner
,
D. D.
, and
Wilkins
,
R. L.
,
2008
, “
Medication Adherence Issues in Patients Treated for COPD
,”
Int. J. Chronic Obstruct. Pulm. Dis.
,
3
(
3
), pp.
371
384
.
10.
Sanchis
,
J.
,
Gich
,
I.
,
Pedersen
,
S.
, and
Aerosol Drug Management Improvement Team
,
2016
, “
Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time?
,”
Chest
,
150
(
2
), pp.
394
406
.
11.
Stein
,
S. W.
,
Sheth
,
P.
,
Hodson
,
P. D.
, and
Myrdal
,
P. B.
,
2014
, “
Advances in Metered Dose Inhaler Technology: Hardware Development
,”
AAPS PharmSciTech
,
15
(
2
), pp.
326
338
.
12.
Furst
,
S. J.
, and
Seelecke
,
S.
,
2014
, “
Fabrication and Characterization of a Dual-Joint Smart Inhaler Nozzle Actuated by Embedded Sma Wires
,”
Smart Mater. Struct.
,
23
(
3
), p.
035008
.
13.
Patel
,
M.
,
Pilcher
,
J.
,
Travers
,
J.
,
Perrin
,
K.
,
Shaw
,
D.
,
Black
,
P.
,
Weatherall
,
M.
, and
Beasley
,
R.
,
2013
, “
Use of Metered-Dose Inhaler Electronic Monitoring in a Real-World Asthma Randomized Controlled Trial
,”
J. Allergy Clin. Immunol.: Pract.
,
1
(
1
), pp.
83
91
.
14.
Chan
,
A. H. Y.
,
Harrison
,
J.
,
Black
,
P. N.
,
Mitchell
,
E. A.
, and
Foster
,
J. M.
,
2015
, “
Using Electronic Monitoring Devices to Measure Inhaler Adherence: A Practical Guide for Clinicians
,”
J. Allergy Clin. Immunol.: Pract.
,
3
(
3
), pp.
335
349
.
15.
Burgess
,
S. W.
,
Wilson
,
S. S.
,
Cooper
,
D. M.
,
Sly
,
P. D.
, and
Devadason
,
S. G.
,
2006
, “
In Vitro Evaluation of an Asthma Dosing Device: The Smart-Inhaler
,”
Respir. Med.
,
100
(
5
), pp.
841
845
.
16.
Goodman
,
D. E.
, and
Rubsamen
,
R. M.
,
1995
, “
Delivery of Aerosol Medications for Inspiration
,” U.S. Patent No. 5,404,871.
17.
Weaver
,
L.
, and
Utter
,
B.
,
2017
, “
Shape Memory Alloy Actuation of a Metered-Dose Inhaler
,”
ASME
Paper No. SMASIS2017-3853.
18.
Kim
,
W.
,
Barnes
,
B. M.
,
Luntz
,
J. E.
, and
Brei
,
D. E.
,
2011
, “
Conglomerate Stabilization Curve Design Method for Shape Memory Alloy Wire Actuators With Cyclic Shakedown
,”
ASME J. Mech. Des.
,
133
(
11
), p.
111010
.
19.
Goodman
,
D. E.
,
Israel
,
E.
,
Rosenberg
,
M.
,
Johnston
,
R.
,
Weiss
,
S. T.
, and
Drazen
,
J. M.
,
1994
, “
The Influence of Age, Diagnosis, and Gender on Proper Use of Metered-Dose Inhalers
,”
Am. J. Respir. Crit. Care Med.
,
150
(
5 Pt 1
), pp.
1256
1261
.
20.
Quanjer
,
P. H.
,
Tammeling
,
G. J.
,
Cotes
,
J. E.
,
Pedersen
,
O. F.
,
Peslin
,
R.
, and
Yernault
,
J. C.
,
1993
, “
Lung Volumes and Forced Ventilatory Flows
,”
Eur. Resp. J.
,
16
, pp. 5–40.
21.
Fryar
,
C. D.
,
Gu
,
Q.
,
Ogden
,
C. L.
, and
Flegal
,
K. M.
,
2016
, “
Anthropometric Reference Data for Children and Adults: United States, 2011–2014
,” Vital and Health Statistics, Series 3, Analytical Studies,
39
, pp. 1–46.
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