CapMedic® (Cognita Labs, California, USA)
CapMedic is an EMD which uses animation with lights and sounds to guide the user through correct inhaler use, recording the seven steps of inhalation, including the mean inspiratory flowrate (L/Min). It fits onto most pMDI’s and provides prompts based on the user’s actions; for example to guide the user to shake their inhaler correctly. It also detects the user’s breathing and nudges the patient with audio-visual cues to press the inhaler while breathing in, followed by reminders to encourage a long inhalation. LED lights then provide the user with immediate feedback on how well the inhaler was used. As with many of the new EMDs, data is synced to an application providing data on both use and critical errors. The CapMedic can also provide lung function measurements including peak inspiratory flow and spirometry. It is currently only available for use with pMDIs(45).
In a small study of 23 patients with asthma and COPD, the CapMedic EMD identified that 100% of patients made at least one error and 74% made at least 3 errors in using a pMDI (46). The CapMedic tool was was considered to be more sensitive in identifying and quantifying these errors than observation alone. Another small study of 16 patients showed improved inhaler technique for patients using CapMedic, compared to patients who were shown an inhaler technique video only(47).