Inspiratory capacity and inhalation techniques evaluated and training by digital therapy comprehensive management platform in COPD patients

BACKGROUND: Inhalation therapy is the main pharmaceutical treatment for patients with chronic obstructive pulmonary disease (COPD), but the improper selection and incorrect use of inhalation devices are widespread. The digital therapy comprehensive management platform (DT-CMP) has the potential to change this situation. METHODS: The inspiratory capacity and inhalation techniques of 64 COPD patients were evaluated and trained by a DT-CMP. Moreover, 60 patients newly diagnosed with COPD and required (pressurized metered dose inhalers) pMDIs were recruited to compare the correct usage rates of inhalation devices after training through self-study based on the instructions, video teaching, and DT-CMP. Additionally, two cases of using DT-CMP for inhalation device training were described. RESULTS: The data indicated that peak inspiratory flow (PIF) decreased with the increase of internal resistance of inhalers and positively correlated with maximum inspiratory pressure (MIP), but no significant correlation with forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1% prediction and FEV1/FVC. Usage errors rate of initial evaluation of DPIs was 50%, and decreased to 16.67% after training of DT-CMP. Among these patients, 50% had insufficient effective inspiratory time, and 16.67% had insufficient inspiratory flow rate. Usage errors rate of initial evaluation of pMDIs was 75%, and decreased to 10% after training. Among these patients, 25% had hand and mouth incoordination, 70% had insufficient effective inhalation time. We also found the most frequency errors were 'sit up/stand straight & tilt head', 'breath out completely before inhalation', 'hold breath (for at least 5 s)', followed by 'hold breath' and 'hand and mouth incoordination'. And the incidence of errors in the digital therapy group was significantly lower than that in self-study group and video teaching group. CONCLUSION: The assessment of combination of checklist with DT-CMP is more comprehensive and effective than the checklist alone for evaluation and training of inspiratory capacity and inhalation techniques. DT-CMP is expected to become an important tool for assessment and training of inspiratory capacity and inhalation technique.