Table 1.

Poor metered-dose inhaler technique is associated with increased likelihood of inhaled corticosteroid overuse among patients with chronic obstructive pulmonary disease

	Adequate MDI Technique	Poor MDI Technique	P Value
No. of subjects	51	44
ICS overuse, n (%)	13 (25)	18 (41)
Crude prevalence ratio (95% CI)	1 (Reference)	1.6 (1.0–2.6)	0.05
Adjusted prevalence ratio* (95% CI)	1 (Reference)	2.4 (1.8–3.2)	<0.001

Definition of abbreviations: CI = confidence interval; ICS = inhaled corticosteroid; MDI = metered-dose inhaler.

^*Adjusted for age, sex, race, congestive heart failure, coronary artery disease, obesity, modified Medical Research Council dyspnea scale score, Global Initiative for Chronic Obstructive Lung Disease stage of airflow obstruction, and spacer use.