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. 2011 Jun 23;6:353–363. doi: 10.2147/COPD.S18529

Table 4.

Percentage of patients correctly completing each item of the checklists on Day 1 and Day 7

(a) Breezhaler checklist Day 1 Day 7 (b) HandiHaler checklist Day 1 Day 7
1. Pull off cap 100.0 100.0 1. Open the cap 98.8 97.5
2. Open mouthpiece 98.8 100.0 2. Open mouthpiece 96.3 97.5
3. Remove capsule from blister pack 98.8 100.0 3. Remove capsule from blister pack 93.8 97.5
4. Insert capsule in the inhaler 100.0 100.0 4. Insert capsule in the inhaler 98.8 100.0
5. Close inhaler – click heard 98.8 98.8 5. Close inhaler – click heard 98.8 98.8
6. Pierce the capsule 95.1 98.8
6. Was the mouthpiece facing upwards? 96.3 97.5 7. Pierced once only 92.7 91.4
7. Pierce the capsule 97.5 96.3 8. Click/piercing noise heard by assessor 92.7 100.0
8. Pierced once only 95.1 90.0 9. Was inhaler held upright? 89.0 88.9
9. Click/piercing noise heard 93.8 95.0
10. Were both buttons pressed simultaneously? 95.1 97.5
11. Release buttons 90.2 97.5 10. Release button 88.9 96.3
12. Were buttons fully released before inhalation?a 92.7 96.3 11. Was button fully released before inhalation?a 87.7 98.8
13. Breathe out – not into mouthpiecea 84.1 85.2 12. Breathe out – not into mouthpiecea 80.2 81.3
13. Was inhaler held horizontally during inhalation? 85.2 95.0
14. Inhale the medicine rapidly and steadily 87.8 93.8 14. Inhale the medicine slowly and deeply 88.9 93.8
15. Were the air inlets unobstructed by fingers? 92.7 91.4 15. Were the air inlets unobstructed by fingers? 91.4 95.0
16. Audible whirring noise 82.9 91.4
17. Hold breath for as long as is comfortable 84.1 77.8 16. Hold breath for as long as is comfortable 75.3 86.3
18. Check upon whether capsule has been fully emptied 80.5 77.8
19. If residue is remaining in capsule, did patient close inhaler and repeat steps 13–18 82.1 80.8 17. Did the patient repeat steps 12–16 to ensure full dose was taken from capsule? 69.1 83.8
20. Open inhaler, remove capsule, close inhaler and replace cap 95.1 96.3 18. Open cap, remove capsule, close and replace cap 88.9 97.5
21. Was capsule pierced at both ends? 93.9 98.8 19. Was capsule pierced at both ends? 95.1 96.3
a

Note: Prespecified as a particularly critical step.