Rafi-Tone – Clinicians

How can Rafi-Tone help my paediatric patients?

Giving inhalers to young children who can’t always understand why they need to be given can often be a difficult task. When young children become upset when using their inhaler and spacer, not only does this put significant stress on the family, but it can also impact the amount of medication the child is receiving1It can be a daunting process for parents and carers to cope with at home without the support of their doctor or nurse.

If the inhaler and spacer technique is not right it might mean the medication isn’t being as effective as it could be. The positive coaching whistle in the Able Spacer mask gives an audible signal that the correct technique is being used. This means there is a good seal between the child’s face and the mask and they are inhaling at an adequate rate (sufficient to open the valve and empty the chamber).

The Rafi-Tone app adds to this by engaging the child’s attention. They quickly learn that making the mask whistle causes the game to progress. This takes the stress out of using an inhaler for children, ultimately helping them to get their correct medication dose. 

The app also helps parents to keep track of when the inhaler has been used – which is especially useful if frequent doses are required.

All that’s needed to use Rafi-Tone is the widely available Able Spacer and the power of your mobile phone. The spacer mask has an audible signal when it is used correctly. This sound drives the Rafi-Tone app. Click here to find out more about Able Spacer.

We know from feedback from parents the audible feedback together with the app allows them to feel empowered and confident in delivering the medication in their own home and are more likely to use the spacer every time they give the inhaler.

“Children feel a sense of achievement when they know they can perform their inhaler technique.” – Primary Care Nurse

Want to try Rafi-Tone now?
Children using Rafi Tone are less likely to get upset.*
Children using Rafi Tone are less likely to get upset.*

What evidence is there to support the use of Rafi-Tone?

Rafi-Tone was conceived by Tariq Aslam initially to help his own son Rafi, read more about Tariq’s story here. The first evidence that it wasn’t just Rafi who was having these problems and that the same approach of using computer games could help was published in the journal Pulmonary Therapy. 
The use of Rafi-Tone in primary care
In 2019 we completed an evaluation with 112 children with support from Salford Clinical Commissioning Group (CCG). Children already using inhalers and their parents were asked to complete a questionnaire before and after using Able Spacer/Rafi-Tone.
What were the results of this evaluation?
We saw improvements in the children’s acceptance of the mask and spacer2 , with knock-on improvements in parents reporting they used the spacer every time they give the inhaler and that they use the preventer inhaler every day. Reported symptoms and the need to visit the GP or A+E for their child’s asthma was also reduced.
Graph picture
When using Rafi-Tone parents reported fewer symptoms3

Where can I read more?

This data was published at the International Society of Aerosol Medicine (ISAM) annual conference and the Primary Care Respiratory Society (PCRS) congress.

What can I do if Rafi-Tone is not available in my country?

Rafi-Tone is currently available in a limited number of countries where Able Spacer is also available.

If Rafi-Tone is currently not available where you are, just get in touch so we can advise if and when it will become available.

What else do I need to know?

Is Rafi-Tone a medical device?

Rafi-Tone (available for Android and iOS devices) is classified as a medical device accessory under the Medical Device Regulation (EU) 2017/745 and has an CE mark to demonstrate it conforms to the regulation.

Has Rafi-Tone been approved by medical app review bodies?

Rafi-Tone has been approved by ORCHA – scoring 83% in the latest assessment. It is also listed on the NHS Digital Apps library and can be recommended to patients via the EMIS app library.

Rafi Tone is CE marked and approved by ORCHA, and is listed on the NHS Digital App Store.​ Data published at 2019 PCRS annual conference.

How do I use Rafi-Tone?

1: Download the app

Once you have your Able Spacer/whistle mask set it up following their instructions, search for and download Rafi-Tone or Rafi-Tone INT from the Apple App Store (iOS) or Google Play Store (Android).

If Rafi-Tone or Rafi-Tone INT is not yet available in your country and you would like to use it then please get in touch with us.

2: Open the app on your tablet or mobile phone

On first use, Rafi-Tone will take you through a check to ensure it can access your device’s microphone and is recognising the whistle in your mask.

Please carry out this check without administering medication.

If at any time you are concerned about the whistle detection you can revisit this screen from the settings menu.

3: Work through the Demo

The short demo will show you how to use all features of the app – you can easily access this again at any time from the information (i) menu.

4: Introduce your child to the Rafi-Tone app

Before giving your child their inhaler show them Rafi-Tone and select ‘Play Game’. Show them how they should make a whistling sound from the mask and that this will help Rafi the Robot overcome his challenge.

When it’s time to take the inhaler, find a quiet environment with little noise or other distractions. Encourage your child to use the spacer whilst watching the screen.

Your privacy

The Rafi-Tone app requires permission to access the device microphone to detect when a tone signal is heard from specific masks or other specific tone generators. There is no other use of the microphone data. No microphone data is stored, transmitted or disclosed to the developer or other parties by this app.

The app has an Inhaler Tracker feature which automatically provides an indication as to when the game has been played. It is also possible to manually add additional data, including personalised notes. The data stored in the Inhaler Tracker is not transmitted or disclosed to other parties (including the developer) by this app. The data may be exported by the user at their own discretion. All data persists only within the app on the device.

No personal, sensitive or identifiable information is stored, transmitted or disclosed to the developer or other parties by this app.

For full information on how we protect and manage your data please view our company Privacy Policy.

Extra information

More information and instructions for use can be found in the app or may be downloaded here:

For previous versions of these instructions please see here.

To obtain a paper version of these instructions please contact us at info@clin-e-cal.com

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