Table 2

The overall number of mistakes in each step at the three visits

Step number and details1st visit2nd visit3rd visitp Value
1. Remove the protective cap from the MDI mouthpieceNS
2. Shake the MDI21614454<0.001
3. Breathe out as far as comfortable348236198<0.001
4. Place the MDI mouthpiece between the teeth and seal with the lips384355322<0.001
5. Ensure your tongue does not obstruct the mouthpieceNS
6. Depress the inhaler to release the dose at the start of inhalationNS
7. Maintain a slow inhalation rate until the lungs are full*385397334<0.001
8. Remove the MDI from the mouth and hold your breathe for 5–10 s332247124<0.001
9. If more than one dose is being taken, wait about 30 s before taking the next dose277229140<0.001
10. Rinse the mouth and if possible brush the teeth after dosing18712351<0.001
11. Replace the cap on the MDINS
Total number of mistakes212917311223<0.001
  • *No significant difference between the first and second visit. Cochran test followed by McNemar test.

  • MDI, metered dose inhaler; NS, no significant difference,