Asieh Hatefi - Pulmonologist, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Ali Emadzadeh - Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahnaz Amini - Pulmonologist, Lung Diseases Research Center, Division of Sleep Medicine, Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Nasrin Milani - Pulmonologist, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: Chronic obstructive pulmonary disease (COPD) is a common medical problem. The improper implementation of inhaler techniques thatare used in such patients leads to the reduced effect of medicines. This study was conducted to evaluate the correct use of various inhalers among COPD patients. Materials and Methods:This observational, cross-sectional study was carried out on ۹۶ patients with COPD aged over ۴۰ years. The samples were selected using asystematic random samplingmethod from patients with COPD referring to the clinics of Ghaem and Imam Reza hospitals, Mashhad, Iran, from March ۲۰۱۸ to March ۲۰۱۹. The subjects were informed that their participation in the study was voluntary. These cases were under the treatment of using at least one inhaled medicine for a month or more. The adopted technique of applying four types of inhalers was evaluated by a standard checklist. The patients' performance scores of all procedures were recorded, and the collected data were analyzed in SPSS software (version ۱۶). Results: Our study revealed that more than ۹۸% of patients used metered-dose inhaler (MDI) spray (P=۰.۰۵). The patients' scores on the correct use of MDI, Diskus, Turbuhaler, and HandiHaler inhalers were estimated at ۶۸, ۷۷, ۸۷, and ۹۰%, respectively. The most common mistakes in using MDI and HandiHaler inhalers were related to the 'holding the breath' and "taking a deep inhale' steps after using the inhaler, respectively. Conclusion: Physicians must evaluate and modify the use of inhalers in every COPD patient. It is recommended that easy-to-use inhalers, such as HandiHaler, be prescribed for such patients.

Chronic Obstructive, Pulmonary Disease, Inhalation devices, Technique