What technology is the focus of this analysis, what functionality does it have, and what problem does it address?
Inhalers:
Metered-Dose Inhalers- These types of handheld inhalers contain a liquid medication that is distributed to the airways in aerosol form. In order to properly use this type of inhaler, one must press on the inhaler while inhaling the medication. It sends a specific amount of medication each time the button is pressed using a propellant spray. It consists of a plastic outer shell encompassing a pressurized container.
Dry Powder Inhaler- As an alternate to metered-dose inhalers, dry powder inhalers deliver medication in the form of dry powder instead of in aerosol form. Medication is held within a plastic outer shell in a capsule. These types of inhalers are not normally used in children due to complications in correct dosage procedure.
Soft Mist Inhaler- This type of handheld inhaler provides the user with an easy inhalable slow-moving mist. Unlike MDI’s and DPI’s, SMI’s does not depend on the user’s ability to breathe air in quickly.
Above image from https://www.respimat.com/functions_and_use/howitworks.html N ebulizers- A nebulizer is a device that converts liquid medication into mist to create a medication that easier to inhale into the lungs. These are often used with younger children who may not be comfortable or capable of using the typical handheld inhalers. Nebulizers are much less mobile than inhalers as well as more expensive. They require a mouthpiece or mask.
Inhaler medical products containing chlorofluorocarbons (CFCs) – exhausts from inhaler have been contributing to the depletion of an upper layer of the ozone. Replaced with hydrofluoroalkanes (HFA). “The replacement of chlorofluorocarbons propellants with hydrofluoroalkanes (HFA) resulted in the redesign of metered-dose inhalers in the 1990s. For one variety of beclomethasone inhaler, this redesign resulted in considerably smaller aerosol particles being produced, and led to an increase of potency by a factor of 2.6”. CFC inhalers manufacturing was terminated due to the international agreement, Montreal Protocol on Substances that Deplete the Ozone Layer, due to the harmful effects.
HFA inhalers cost more to patients than previously used CFC inhalers.
Following annotations are based on MDI’s:
What organizational setting and dynamic was the technology developed in, and who was involved in its development? MDI’s were originally developed by Riker laboratories (3M Healthcare) in 1955. The main aim of the design was to make the MDI smaller and more easily transportable than existing nebulizers.
What participants were notably absent in the design and development of the project? The most common with the MDI is its actuation. The ability to utilize the MDI to its maximum potential is based on the patients inhale technique. If the patients inhale is not synchronized with the actuation of the inhaler, the effectiveness of the inhaler decreases significantly.
What motivated design and development of the technology, and how do project designers and developers articulate its "design logic"?
MDI’s were designed to be convenient and portable relative to nebulizers. HFA inhalers were designed to mimic CFC inhalers due to the familiarity among product and patient. The design was regulated by the Committee for Proprietary Medicinal Products (CPMP) regulatory requirements. The CPMP was replaced by the Committee for Medicinal Products for Human Use (CHMP). Both committees are based on the European Union and each member state is represented within the committee.
Patients have noticed differences between CFC inhalers and HFA inhalers. HFA inhalers have a a wamer, “softer” spray that patients associate with a lack of utility.
Many iterations of the MDI have been developed:
Breath Coordinated Inhalers- These inhalers are described as breath coordinated rather than breath actuated. No matter how it is used, the patients inhale will synchronize with actuation. Autohaler was one of the first products to use breath actuation.
oHow has the project been funded, and how has this shaped the project? How did the project evolve?
The original Autohaler encountered many problems with loudness and maintaining a “flow” generation. The project was then funded by 3M Pharmaceutical where it became a widely used inhaler to improve lung deposition.
Spacehalers- The “spacehaler” was designed to reduce the velocity of the spray. This would ideally provide improved lung deposition.
oHow has the project been funded, and how has this shaped the project? How did the project evolve?
Tempo Inhaler- As said by the developers, the Tempo inhaler is “an innovative next generation MDI.” It was designed to improve upon the MDI’s most basic downfalls- dosing inconsistency, inefficient drug delivery, and patient/product synchronization.
oHow has the project been funded, and how has this shaped the project? How did the project evolve?
Product evolved into treatment for acute migraines.
BronchoAir- MDI still in development that is supposed to use a series of air jets to improve lung deposition.
What is the development history of the technology? What previous technologies were used by those involved?
Before the MDI’s, nebulizers were often used.
What data is produced by or associated with the technology, and how has this implicated its development? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952300/ (Evaluation of Inhaler Techniques Among Asthma Patients Seen in Nigeria: An Observational Cross Sectional Study)
What significant setbacks have impacted development of the technology?
FDA approval rates are slow. Many regulations are enforced across numerous nations. http://www.ncbi.nlm.nih.gov/pubmed/19075871 (difficulties in further developing dry powder inhalers)
How has the technology been used, and what do users say about the technology? Who has had access to and used the technology?
Each individual with asthma needs to have an inhaler that servers there needs completely. Unfortunately, many doctors end up prescribing an inhaler that is not offered as a generic brand. Even though it is the best option for a patient, it cannot be easily afforded with the healthcare system and pharmaceutical companies in the United States.
What will create the most significant barriers to further development and dissemination of this technology?
Regulatory committees
What broad social, political, economic and cultural trends have and will likely continue to affect the development, use and impact of the technology?
Air pollution, pharmaceutical companies, regulatory committees, health insurance, etc. (look more deeply into this)
2.)Who uses the technology, and how did they access it? What costs are associated with use?
3.)What do users do with the technology, with what frequency and in what kinds of instances and spaces?
4.)What motivates use of the technology by different kinds of users? What promotes confidence in the technology?
5.)What are the e/affects of use of the technology by different users? Does the technology change user behaviour or perceptions? What kinds of social or political interactions result from use of the technology?
6.)What adaptions have users made to the technology, and why?
7.)Are there users who are actively experimenting with the technology to push its development and possible application?
8.)Who and how is use of the technology being tracked and evaluated?
9.)What is your (the analyst’s) evaluation of the technology? What is your reading of the design logics of the technology? What is your reading of the design effects of the technology?
10.)Additional questions that should be asked about technology users?
Inhalers:
Metered-Dose Inhalers- These types of handheld inhalers contain a liquid medication that is distributed to the airways in aerosol form. In order to properly use this type of inhaler, one must press on the inhaler while inhaling the medication. It sends a specific amount of medication each time the button is pressed using a propellant spray. It consists of a plastic outer shell encompassing a pressurized container.
Above image from http://www.asthma.ca/adults/treatment/meteredDoseInhaler.php
Dry Powder Inhaler- As an alternate to metered-dose inhalers, dry powder inhalers deliver medication in the form of dry powder instead of in aerosol form. Medication is held within a plastic outer shell in a capsule. These types of inhalers are not normally used in children due to complications in correct dosage procedure.
Above image from http://www.asthma.ca/adults/treatment/diskus.php
Soft Mist Inhaler- This type of handheld inhaler provides the user with an easy inhalable slow-moving mist. Unlike MDI’s and DPI’s, SMI’s does not depend on the user’s ability to breathe air in quickly.
Above image from https://www.respimat.com/functions_and_use/howitworks.html
N
ebulizers- A nebulizer is a device that converts liquid medication into mist to create a medication that easier to inhale into the lungs. These are often used with younger children who may not be comfortable or capable of using the typical handheld inhalers. Nebulizers are much less mobile than inhalers as well as more expensive. They require a mouthpiece or mask.
Above image from http://cdn.nursingcrib.com/wp-content/uploads/2011/09/nebulizer.gif
Environmentally friendly change made to inhalers recently?
http://consumer.healthday.com/respiratory-and-allergy-information-2/asthma-news-47/environmental-concerns-led-to-jump-in-cost-of-asthma-inhalers-study-699310.html
http://www.consumer-health.com/services/WhatEveryAsthmaPatientNeedstoKnowAbouttheNewHFAInhalers.php
Inhaler medical products containing chlorofluorocarbons (CFCs) – exhausts from inhaler have been contributing to the depletion of an upper layer of the ozone. Replaced with hydrofluoroalkanes (HFA). “The replacement of chlorofluorocarbons propellants with hydrofluoroalkanes (HFA) resulted in the redesign of metered-dose inhalers in the 1990s. For one variety of beclomethasone inhaler, this redesign resulted in considerably smaller aerosol particles being produced, and led to an increase of potency by a factor of 2.6”. CFC inhalers manufacturing was terminated due to the international agreement, Montreal Protocol on Substances that Deplete the Ozone Layer, due to the harmful effects.
HFA inhalers cost more to patients than previously used CFC inhalers.
Following annotations are based on MDI’s:
What organizational setting and dynamic was the technology developed in, and who was involved in its development?
MDI’s were originally developed by Riker laboratories (3M Healthcare) in 1955. The main aim of the design was to make the MDI smaller and more easily transportable than existing nebulizers.
What participants were notably absent in the design and development of the project?
The most common with the MDI is its actuation. The ability to utilize the MDI to its maximum potential is based on the patients inhale technique. If the patients inhale is not synchronized with the actuation of the inhaler, the effectiveness of the inhaler decreases significantly.
What motivated design and development of the technology, and how do project designers and developers articulate its "design logic"?
MDI’s were designed to be convenient and portable relative to nebulizers. HFA inhalers were designed to mimic CFC inhalers due to the familiarity among product and patient. The design was regulated by the Committee for Proprietary Medicinal Products (CPMP) regulatory requirements. The CPMP was replaced by the Committee for Medicinal Products for Human Use (CHMP). Both committees are based on the European Union and each member state is represented within the committee.
Patients have noticed differences between CFC inhalers and HFA inhalers. HFA inhalers have a a wamer, “softer” spray that patients associate with a lack of utility.
Many iterations of the MDI have been developed:
Breath Coordinated Inhalers- These inhalers are described as breath coordinated rather than breath actuated. No matter how it is used, the patients inhale will synchronize with actuation. Autohaler was one of the first products to use breath actuation.
Spacehalers- The “spacehaler” was designed to reduce the velocity of the spray. This would ideally provide improved lung deposition.
Tempo Inhaler- As said by the developers, the Tempo inhaler is “an innovative next generation MDI.” It was designed to improve upon the MDI’s most basic downfalls- dosing inconsistency, inefficient drug delivery, and patient/product synchronization.
BronchoAir- MDI still in development that is supposed to use a series of air jets to improve lung deposition.
What is the development history of the technology? What previous technologies were used by those involved?
Before the MDI’s, nebulizers were often used.
What data is produced by or associated with the technology, and how has this implicated its development?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952300/ (Evaluation of Inhaler Techniques Among Asthma Patients Seen in Nigeria: An Observational Cross Sectional Study)
What significant setbacks have impacted development of the technology?
FDA approval rates are slow. Many regulations are enforced across numerous nations.
http://www.ncbi.nlm.nih.gov/pubmed/19075871 (difficulties in further developing dry powder inhalers)
How has the technology been used, and what do users say about the technology? Who has had access to and used the technology?
Each individual with asthma needs to have an inhaler that servers there needs completely. Unfortunately, many doctors end up prescribing an inhaler that is not offered as a generic brand. Even though it is the best option for a patient, it cannot be easily afforded with the healthcare system and pharmaceutical companies in the United States.
What will create the most significant barriers to further development and dissemination of this technology?
Regulatory committees
What broad social, political, economic and cultural trends have and will likely continue to affect the development, use and impact of the technology?
Air pollution, pharmaceutical companies, regulatory committees, health insurance, etc. (look more deeply into this)
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/QuestionsAnswers/ucm077808.htm
http://www.sciencedirect.com/science/article/pii/S095461110400455X
http://www.ema.europa.eu/ema/index.jsp?curl=pages/about_us/general/general_content_000094.jsp
http://www.rcjournal.com/contents/09.05/09.05.1177.pdf
http://www.pharmamanufacturing.com/articles/2015/efficient-development-of-generic-metered-dose-inhalers/?show=all
Observing Technology Users ON NEBULIZERS
1.)What technology is being observed?
2.)Who uses the technology, and how did they access it? What costs are associated with use?
3.)What do users do with the technology, with what frequency and in what kinds of instances and spaces?
4.)What motivates use of the technology by different kinds of users? What promotes confidence in the technology?
5.)What are the e/affects of use of the technology by different users? Does the technology change user behaviour or perceptions? What kinds of social or political interactions result from use of the technology?
6.)What adaptions have users made to the technology, and why?
7.)Are there users who are actively experimenting with the technology to push its development and possible application?
8.)Who and how is use of the technology being tracked and evaluated?
9.)What is your (the analyst’s) evaluation of the technology? What is your reading of the design logics of the technology? What is your reading of the design effects of the technology?
10.)Additional questions that should be asked about technology users?