1. Summary of characteristics of studies in comparisons 1 and 2: inhaler technique education.
| Study ID | Total n |
Study duration (weeks) |
Age | Country | Intervention | Control | Inhaler technique measure | Outcomes |
| Agertoft 1998 | 72 | 2 | Children aged 3 to 5 years | Denmark | Instructional video + individual training; delivered to participant | Instructional video | PIF | PIF, IVC, PEFR, FEV1, FVC |
| Basheti 2005 | 26 | 2 | Adults | Australia | Group B: verbal counselling Group C: verbal counselling + physical demonstration; delivered to participant |
Group A: printed materials | 9‐Step Turbuhaler checklist | Inhaler technique |
| Basheti 2008 | 31 pharmacists, 97 participants | 26 | Adults | Australia | Pharmacist‐participant education + inhaler technique labels; delivered to pharmacist | Peak flow measurement training | 9‐Step checklist | Inhaler technique, asthma severity, peak flow variability, AQOL, perceived control |
| Bynum 2001 | 49 | 4 | Adolescents aged 12 to 19 years | USA | Telepharmacy counselling; delivered to participant | Written instructions only | 8‐Step MDI checklist | Inhaler technique, participant satisfaction |
| Fernandes 2011 | 89 | 12 | Adults | Not reported | Respiratory therapist education; delivered to participant | Rotuine physician education | Not reported | Inhaler technique, asthma control |
| Mehuys 2008 | 201 | 26 | Adults | Belgium | Pharmacist education; delivered to pharmacist | Usual pharmacy care | 10‐Step MDI + spacer checklist/8‐step DPI checklist | Inhaler technique, ACT, exacerbations, ED/hospital visits, adherence, AQLQ, asthma knowledge |
| Nahafizadeh 2010 | 46 | 8.7 | Adults | Iran | Face‐to‐face education; delivered to participant | Usual care (no further details) | Not reported | ACT, FEV1 |
| Ozkaya 2010 | 130 | 12 | Children | Turkey | Face‐to‐face nurse training; delivered to participant | Inhaler package insert only | 10‐Step MDI checklist | Inhaler technique, PAQLQ, spirometry |
| Rahmati 2014 | 90 | 4 | Adults | Iran | Face‐to‐face training (no spacer device); delivered to participant | Usual care (no training) | 11‐Step MDI checklist | Inhaler technique, PEFR |
| Rydman 1999 | 68 | 8 to 20 | Adults | USA | Face‐to‐face training + demonstration; delivered to participant | Inhaler package insert only | Checklist, converted to score out of 1 (0 if any steps missed) | BAI and MDI competency |
| Self 1983 | 29 | 1 to 16 (mean 6) | Adults | USA | Face‐to‐face pharmacist training; delivered to participant | Inhaler package insert only | 10‐Step checklist | Inhaler technique, "effectiveness of instruction" |
| Turgeon 1996 | 96 | 26 | Children and adolescents (max 15 years) | Canada | Interactive nurse training with feedback; delivered to participant | Pictorial nurse training only | Checklist with scores converted to percentages | Inhaler technique, parental perceptions of treatment, asthma morbidity (e.g. no. of exacerbations, ED visits, hospitalisations, days of schools missed) |
ACT: Asthma Control Test; AQLQ: Asthma Quality of Life Questionnaire; AQOL: asthma quality of life; BAI: breath‐activated inhaler; DPI: dry powder inhaler; ED: emergency department; FEV1: forced expiratory volume in one second; FVC: forced vital capacity; IVC: inspiratory vital capacity; MDI: metered dose inhaler; PAQLQ: paediatric AQLQ; PEFR: peak expiratory flow rate; PIF: peak inspiratory flow