Margolis 2013.

Study characteristics
Methods	Design: prospective, randomised, single‐blinded intervention study (unpublished) Duration: 26 weeks Location: USA Setting: counselling by telephone
Participants	Population: 97 adult veterans with COPD, randomised into a counselling intervention (n = 49) or control group (n = 48) Baseline characteristics COPD severity: unclear Age (mean): intervention 71.6 years; control 70.9 years % males: 97.9% of sample Oxygen use (%): intervention 26.5%; control 26.7% Inclusion criteria: aged ≥ 60 years were identified by pharmacy EMR for tiotropium or LABA (or both) with or without an ICS, low adherence by refilling ≥ 1 daily inhaler < 80% of the time over the previous 6 months Exclusion criteria: age < 60 years, cognitive disorder, severe hearing impairment, < 4 months from initial prescription date, activated healthcare power of attorney
Interventions	Treatment arms Counselling intervention: telephone‐based Control group Allowed co‐medications: tiotropium or LABA (or both) with or without ICS as part of inclusion. No other medications reported
Outcomes	Primary outcomes: incorrect inhaler directions, LABA directions, ICS directions, MDI directions, holding breath, exhaling, LABA breath, MDI inhalation, MDI: wait between puffs, ICS breath, ICS: rinse and spit Secondary outcomes: not reported
Notes	Funding: ASHP Research and Education Foundation Fostering Young Investigators Federal Services Junior Investigator Research Grant Identifiers: DOI 10.2146/ajhp120241 (1 letter, 2 posters)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Participants were randomised using a computer‐generated random number sequence.
Allocation concealment (selection bias)	Unclear risk	Not reported.
Blinding of participants and personnel (performance bias) all outcomes	High risk	Not possible to blind participants or personnel due to nature of intervention.
Blinding of outcome assessment (detection bias) all outcomes	High risk	Not reported, but unlikely to be blinded due to nature of intervention.
Incomplete outcome data (attrition bias) all outcomes	Low risk	No dropouts or deaths in the intervention group, 2 deaths and 1 dropout in the control group, but overall low (6%).
Selective reporting (reporting bias)	Unclear risk	Trial was registered on trial registry website; however, results were reported in a conference poster and a published letter only with no further publication.
Other bias	Low risk	None identified.