TY - JOUR T1 - The effect of Clip-tone® and its smartphone application on optimization of metered-dose inhaler inhalation technique JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.4157 VL - 56 IS - suppl 64 SP - 4157 AU - Waleed Wael AU - Mark J Sanders AU - Raghda R.S. Hussein AU - Rania M. Sarhan AU - Waleed Ramadan AU - Mohamed Abdelrahim Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/4157.abstract N2 - Background: While pMDI are extensively prescribed, its use frequently results in repetitive inhalation-techniques mistakes.One of the most repetitive errors is inhaling too fast through the pMDI.Aims and Objectives: The aim of the present study was to assess the effect of Clip-tone® with linked smartphone application on the inhalation-flow of subjects.Methods: 200 subjects were involved in the study. They were randomized into 4 groups. Group 1 received only verbal pMDI counseling; group 2 received verbal counseling plus resistance (a modified Clip-tone® with no whistle); group 3 received verbal counseling with whistle as audio feedback from normal Clip tone® and group 4 received verbal counseling with whistle from Clip-tone® and visual feedback (smartphone application). Inhalation time through the pMDI for each subject was recorded three times and inter and intra-subject variations were calculated.Results: Group 4 showed 37 subjects with correct inhaling flow (5 seconds) with the lowest variation between subjects (inter-subject variability) and lowest intra-personal variability. While group 3 showed 45 subject having correct flow (5 seconds); their’ inter and intra-subject variations were lower when compared with groups 1 and 2 which had 28 and 20 subjects respectively with inhalation-time about 5-seconds.Conclusions: Providing visual and audio-feedbacks by the Clip-tone® with smartphone application preserved the deep and slow inhalation over the pMDI much better compared to verbal counseling alone. We recommend the patients to take all their inhaled doses using pMDI add-on devices e.g. Clip-tone® with smartphone application.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4157.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -