Table 3.

Inhaler technique scores attained by respondents when assessed by survey providing clinician, for dry powder and metered dose inhalers.

Inhaler technique score (/6)	Number of respondents attaining score for dry powder inhalers (DPI) (n = 68)	Inhaler technique score (/5)	Number of respondents attaining score for metered dose inhaler (MDI) (n = 123)
1	2 (3%)	1	5 (4%)
2	2 (3%)	2	14 (11%)
3	6 (9%)	3	27 (22%)
4	14 (21%)	4	37 (30%)
5	21 (31%)	5	40 (33%)
6	23 (34%)

Score were assessed as per the instructions on the audit proforma (appendix). Patients received a point for each correctly attained step in inhaler usage to generate a score /6 for DPI and /5 for MDI.

Summary of steps:

DPI

1. Prepare the inhaler (as per inhaler, eg shake inhaler, remove mouth piece).

2. Empty lungs.

3. Positioning (sat up straight, chin inclined up).

4. Mouth seal.

5. Fast, deep inhalation.

6. Hold breath for 30 s.

MDI

1. Prepare inhaler e.g. remove mouthpiece, attach spacer.

2. Empty lungs.

3. Positioning (sat up straight, chin inclined up).

4. Mouth seal.

Appropriate inhalation – slow and gentle if no spacer or five tidal breaths if using spacer, plus appropriate spacing between doses if multiple doses.