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. 2014 Sep-Oct;40(5):513–520. doi: 10.1590/S1806-37132014000500007

Table 1. Errors in metered dose and dry powder inhaler techniques, i.e., inhaler technique steps that were performed incorrectly, in the total sample and by age group (N = 143 inhalers).a.

Error Total sample Age group
10-19 years 20-59 years 60 years or older
Metered dose inhaler (n = 94) (n = 24) (n = 61) (n = 9)
Not shaking the inhaler 20 (21.3) 6 (25.0) 11 (18.0) 3 (33.3)
Not holding the mouthpiece vertically 4-5 cm away from the mouth or between the lips 3 (3.2) 1 (4.2) 2 (3.3) 0 (0.0)
Not keeping the mouth open 2 (2.1) 1 (4.2) 1 (1.6) 0 (0.0)
Not exhaling normally 62 (66.0) 16 (66.7) 41 (67.2) 5 (66.0)
Not actuating the inhaler at the start of a slow and deep inhalation 7 (7.5) 1 (4.2) 4 (6.6) 2 (22.2)
Failure to breath-hold for at least 10 seconds after inhalation 27 (28.7) 7 (29.2) 16 (26.2) 4 (44.4)
Not waiting 15-30 seconds prior to each actuationb 45 (57.7) 11 (55.0) 26 (54.2) 8 (88.9)
Dry powder inhaler (n = 49) (n = 4) (n = 29) (n = 16)
Error in dose preparation (all models) 3 (6.1) 0 (0.0) 0 (0.0) 3 (18.8)
Not exhaling normally 23 (46.9) 1 (25.0) 12 (41.4) 10 (62.5)
Not placing the inhaler in the mouth 1 (2.0) 0 (0.0) 0 (0.0) 1 (6.3)
Not inhaling as fast and as deeply as possible 3 (6.1) 0 (0.0) 0 (0.0) 3 (18.7)
Failure to breath-hold for 10 seconds after inhalation 12 (24.5) 0 (0.0) 7 (24.1) 5 (31.3)
Single-dose dry powder inhaler: not inhaling again, more deeply than before, if there is powder left in the capsulec 7 (17.5) 1 (25.0) 2 (8.7) 4 (30.7)