. 2017 Apr 13;27:24. doi: 10.1038/s41533-017-0022-1

Table 1.

Study and intervention characteristics

FFirst author	Disease	Setting	Sessions	Session length (h:mm)	Delivery	Deliverer	N	Inhaler type	Maximum follow-up (months)	Outcome type	Inhaler technique Improvement		Clinical outcomes
											(%)	(p.p.)
Al-Showair 2007¹⁵	Asthma	Outpatient clinic	1	–	Individual	–	107	MDI	1.5	IFR	–		Peak flow:↑, AQLQ: ↑
Armour 2013¹⁶	Asthma	Pharmacy	4	00:26	Individual	Pharmacist	398	MDI	6	Patients		50 p.p.	ACQ:≈
Basheti 2008¹⁷	Asthma	Pharmacy	4	00:03	Individual	Pharmacist	97	DPI	6	Steps	49%		Asthma severity: ↓
Basheti 2005¹⁸	Asthma	Pharmacy	1	00:08	Individual	Researcher	17	DPI	0.5	Steps	75%		None
	Asthma	Pharmacy	1	00:08	Individual	Researcher	17	DPI	0.5	Steps	80%
Bosnic-Anticevich 2010¹⁹	Both	Pharmacy	3	–	Individual	Researcher	52	MDI	4	Steps	38%		None
Bynum 2001²⁰	Asthma*	Outpatient clinic	1	00:15	Individual	Pharmacist	49	MDI	1	Steps	77%		None
Carpenter 2015²¹	Asthma*	Outpatient clinic	1	00:03	Individual	Researcher	91	MDI	1	Steps	16%		ACT: ≈
Chan 2007²²	Asthma*	Outpatient clinic	5	–	Individual	Other	60	MDI	12	Steps	8%		QOL: ≈, hospitalisations: ≈
	Asthma*	Outpatient clinic	5	–	Individual	Other	60	DPI	12	Steps	12%
Chan 2003²³	Asthma*	Outpatient clinic	4	–	Individual	Other	10	Both	6	Steps	–		Peak flow: ↑, QOL: ≈
Cicutto 2013²⁴	Asthma*	School	6	00:53	Group	–	1316	–	12	Steps	48%		QOL:↑, Urgent care:↓
Cordina 2001²⁵	Asthma	Pharmacy	1	–	Individual	–	152	–	12	Patients		36 p.p.	QOL: ↑, peak flow: ↑, hospitalisations: ↓
Crane 2014²⁶	Asthma	–	1	–	Individual	–	123	Both	12	Patients		16 p.p.	None
De Blaquiere 1989²⁷	Both	Outpatient clinic	1	00:17	Individual	Researcher	100	MDI	2	Patients		81 p.p.	Hospitalisations: ≈
De Oliveira 1999²⁸	Asthma	Outpatient clinic	8	–	–	Researcher	42	MDI	6	Patients		73 p.p.	ER visits:↓, symptoms:↓, QOL:↑
Garcia-Cardenas 2013²⁹	Asthma	Pharmacy	3	–	Individual	Pharmacist	336	DPI	6	Patients		56 p.p.	ACQ:↑
Goodyer 2006³⁰	Asthma	–	1	–	Individual	Pharmacist	35	MDI	0	Steps	–		None
	Asthma	–	1	–	Individual	Pharmacist	34	MDI	0	Steps	–
Goris 2013³¹	COPD	Outpatient clinic	1	–	Individual	–	24	MDI	3	Steps	100%		QOL:↑, attacks:↓, hospitalisations:≈
	COPD	Outpatient clinic	1	–	Individual	–	110	DPI	3	Steps	43%
Hesselink 2004³²	Both	Other	2	00:30	Individual	Nurse	276	–	24	Patients		–	QOL: ≈
Horner 2008³³	Asthma*	School	16	00:15	Group	Other	183	MDI	1.5	Steps	36%		None
Kiser 2012³⁴	COPD	Hospital	1	00:23	Individual	Researcher	99	MDI	1.25	Steps	29%		None
	COPD	Hospital	1	00:23	Individual	Researcher	41	DPI	1.25	Steps	22%
	COPD	Hospital	1	00:23	Individual	Researcher	27	DPI	1.25	Steps	20%
Kools 2006³⁵	Asthma	–	1	00:01	Individual	Researcher	50	MDI	0	Steps	–		None
Kritikos 2007³⁶	Asthma	Pharmacy	1	02:30	Group	Pharmacist	22	MDI	3	Patients		73 p.p.	Poor control: ↓, AQOL: ↑
	Asthma	Pharmacy	1	02:30	Group	Pharmacist	25	DPI	3	Patients		79 p.p.
	Asthma	Pharmacy	1	02:30	Group	Researcher	20	MDI	3	Patients		86 p.p.
	Asthma	Pharmacy	1	02:30	Group	Researcher	26	DPI	3	Patients		84 p.p.
Kumar 2009³⁷	Both	Hospital	4	–	Individual	Pharmacist	98	MDI	2	Steps	115%		FEV₁:↑
	Both	Hospital	4	–	Individual	Pharmacist	18	DPI	2	Steps	100%
Martin 2015³⁸	Asthma*	Other	4	–	Individual	Nurse	51	–	12	Steps	50%		Control: ≈
	Asthma*	Other	4	–	Individual	Nurse	50	–	12	Steps	29%
Mehuys 2008³⁹	Asthma	Pharmacy	3	–	Individual	Pharmacist	201	Both	6	Steps	25%		Nighttime symptoms:↓, ACT:↑
Mulloy 1996⁴⁰	Asthma	Outpatient clinic	1	–	Individual	Nurse	60	–	12	Steps	20%		Symptoms: ↓, peak flow: ≈
Patterson 2005⁴¹	Asthma*	School	8	–	Group	Nurse	173	–	4	Patients		38 p.p.	QOL: ≈
Perneger 2002⁴²	Asthma	Hospital	3	01:15	Group	Other	131	–	6	Patients		28 p.p.	QOL: ≈, healthcare utilisation: ≈
Petkova 2008⁴³	Asthma	Pharmacy	5	–	–	Researcher	50	–	4	Patients		14 p.p.	Hospitalisation: ↓, QOL:↑
Press 2012⁴⁴	Both	Hospital	1	00:06	Individual	Researcher	50	MDI	0	Patients		52 p.p.	Health-related events:↓
	Both	Hospital	1	00:06	Individual	Researcher	18	DPI	0	Patients		50 p.p.
Rahmati 2014⁴⁵	Asthma	–	3	–	Group	–	60	MDI	1	Steps	60%		Peak flow: ↑
	Asthma	–	3	–	Group	–	60	MDI	1	Steps	90%
Rootmensen 2008⁴⁶	Both	Outpatient clinic	1	00:45	Individual	Nurse	191	–	6	Steps	3%		QOL: ≈, Exacerbations: ↓
Rydman 1999⁴⁷	Asthma	Outpatient clinic	1	–	Individual	Researcher	68	MDI	3	Patients		36 p.p.	None
Santos 2010⁴⁸	Asthma	Outpatient clinic	2	01:00	Individual	Pharmacist	28	MDI	2	Steps	167%		None
	Asthma	Outpatient clinic	2	01:00	Individual	Pharmacist	28	DPI	2	Steps	33%
Tommelein 2014⁴⁹	COPD	Pharmacy	2	00:20	Individual	Pharmacist	734	Both	3	Steps	38%		Hospitalisations↓
Toumas-Shehata 2014⁵⁰	Asthma	Pharmacy	1	–	Individual	Pharmacist	101	DPI	1	Steps	40%		ACQ:↑
Van der Palen 1997⁵¹	COPD	Outpatient clinic	1	00:45	Group	Nurse	70	Both	9	Steps	26%		None
	COPD	Outpatient clinic	1	00:45	Individual	Other	73	Both	9	Steps	18%
	COPD	Other	1	00:45	Individual	Other	71	Both	9	Steps	26%
Verver 1996⁵²	Asthma	Other	1	–	Individual	Nurse	48	DPI	0.5	Steps	9%		Dyspnoea: ↓
Wilson 1993⁵³	Asthma	Hospital	4	00:45	Individual	Nurse	227	MDI	12	Steps	–		Asthma status: ↑, physical activity: ↑, Acute visits:↓
	Asthma	Hospital	4	01:30	Group	Nurse	229	MDI	12	Steps	–

*: children, ↑: increase/improvement, ↓: decrease/worsening, ≈: no difference, Outcome type: mean number or percentage of correct steps (in the table: “Steps”), the percentage of patients who showed a correct technique (in the table: “Patients”), or inhalation flow rate (IFR). Improvement over baseline is either reported as percentage (%) or as percentage points (p.p.)