Abstract

Objective: To assess the MDI-with-spacer technique among COPD patients and identify factors associated with improper use.
Methodology: This descriptive cross-sectional study included 140 COPD patients aged 40-70 years attending Khyber Teaching Hospital, Peshawar, over six months. Patients’ inhaler technique was evaluated using a validated 9-step checklist. The technique was classified as proper, improper, or poor. Associations with gender, occupation, area of residence, education, and prior guidance were analyzed using Chi-square tests.
Results: Only 24 patients (17.1%) demonstrated proper technique, 67 (47.9%) improper, and 49 (35%) poor. Occupation was significantly associated with technique (p=0.002), while area of residence showed borderline significance (p=0.053). Gender had no significant association (p=0.216). Prior verbal guidance did not ensure proper technique.
Conclusion: The MDI technique among COPD patients is largely suboptimal. Hands-on training, repeated assessment, and tailored education, especially for rural and low-literacy populations, are essential.

Key words: COPD, metered dose inhaler, inhaler technique, spacer, Pakistan, patient education.