Table 2. Percentages of mistakes per step, total percentages of patients making incorrect inhalation techniques per controller device.
| Essential steps | pMDI (n=44) | pMDI with spacer (n=60) |
|---|---|---|
| Shake inhaler thoroughly | 22.7 | 8.3 |
| Remove the cap and keep inhaler in upright position | 11.4 | na |
| Remove cap and insert inhaler correctly into spacer | na | 1.7 |
| Breathe out gently to residual volume | 50.0 | 53.3 |
| Close lips on inhaler or spacer mouthpiece | 0.0 | 0.0 |
| Press the canister at beginning of inhalation | 40.9 | na |
| Hold spacer level and press down firmly on canister once | na | 21.2 |
| Inhale slowly and deeply | 27.3 | 43.3 |
| Hold breath for at least 10 seconds | 27.3 | 48.3 |
| Breath in and out through mouthpiece at least three times | na | 20.0 |
| Patients performing incorrect inhalation techniques | 33 (75.0%) | 49 (81.7%) |
| Patients performing incorrect flow (<30 or >60 L/min) | 28 (63.6%) | 33 (55.0%) |
| Overall (incorrect technique and flow) | 42 (95.5%) | 54 (90.0%) |
pMDI, pressurized metered-dose inhaler; na, not applicable to the device.