Table 2 The number of COPD patients who incorrectly performed a critical step of a prescribed inhalation technique compared between before inhaler use training (baseline) and 1 month after inhaler use training (N = 66)

pMDI (n = 59)

  1. Remove cap

0 (0)

0 (0)

N/A

  2. Keep inhaler in upright position

3 (5.1)

0 (0)

0.250

  3. Shake inhaler vertically 4–5 times

24 (40.7)

9 (15.3)

0.001*

  4. Press the canister 1 time and inhale at the same time

40 (67.8)

24 (40.7)

 < 0.001*

  5. Inhale slowly and deeply

50 (84.7)

35 (59.3)

0.001*

  6. Error at any step

59 (100.0)

49 (83.1)

0.002*

Turbuhaler (n = 11)

  1. Remove cap

0 (0)

0 (0)

N/A

  2. Keep inhaler in upright position

8 (72.7)

5 (45.5)

0.250

  3.Turn red grip anti-clockwise then turn back until it “click”

5 (45.5)

0 (0)

0.063

  4. Breath out gently away from the inhaler to residual volume

4 (36.4)

1 (9.1)

0.250

  5. Inhale forcefully and deeply

7 (63.6)

3 (27.3)

0.125

  6. Error at any step

11 (100.0)

5 (45.5)

0.031*

Accuhaler (n = 11)

  1. Open cover

0 (0)

0 (0)

N/A

  2. Push the lever until it “click”

3(27.3)

1 (9.1)

0.500

  3. Breath out gently away from the inhaler to residual volume

9 (81.8)

1 (9.1)

0.008*

  4. Inhale forcefully and deeply

3 (27.3)

1 (9.1)

0.500

  5. Error at any step

11 (100.0)

3 (27.3)

0.008*

Handihaler/Breezhaler (n = 20)

  1. Open cover

0 (0)

0 (0)

N/A

  2. Insert the capsule into the chamber

0 (0)

0 (0)

N/A

  3. Pierce the capsule by fully pressing the button 1 time and then release

19 (95.0)

8 (40.0)

0.001*

  4. Breath out gently away from the inhaler to residual volume

5 (25.0)

1 (5.0)

0.219

  5. Inhale deeply with capsule vibrating sound

6 (30.0)

3 (15.0)

0.453

  6. Error at any step

20 (100.0)

9 (45.0)

0.001*