Background Incorrect use of inhalers among asthma and COPD patients is very prevalent. Yet, no single intervention is considered standard of care. We aimed to conduct a COPD-specific investigation of active one-on-one coaching as the educational intervention to improve pressurized metered dose inhaler (pMDI) technique and COPD symptoms management. Methods COPD patients who have pMDI in their treatment regimen were enrolled in this prospective study using the Global Initiative for Chronic Obstructive Lung Disease criteria. After rapid cognitive screen, inhaler technique was assessed and an active one-on-one coaching was provided utilizing the 12-step American Thoracic Society instructions. Patients’ inhaler technique was assessed and scored again at their regular follow-up visits. Results One hundred and one patients participated in the study. The percentage of pMDI misuse decreased from 43.5% pre-teaching to 12.9% post-teaching (binomial test p value < 0.001). The mean number of errors decreased from 3.1 errors pre-teaching to 1.7 errors post-teaching (paired t-test p value < 0.001). The number needed to treat was 3.3 patients to prevent one misuse. Patients with an impaired cognitive function were more likely to have inhaler misuse in general and less likely to improve their technique when provided training. Conclusions This study reveals that many COPD patients have incorrect pMDI techniques that can be improved with a short training in the clinic. Trial Registration: Not applicable.

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Objectives: Literature has shown a high prevalence of poor inhaler technique amongst COPD patients throughout the past several decades. We aim to study the patients’ perspective on the use of inhalers to understand how inhaler therapy can be better approached. Methods: COPD patients who were regularly using pressurized metered-dose inhaler(s) (pMDI) with or without spacers were recruited to complete a survey regarding their perception of inhaler use. Results: One hundred and one patients participated in the study. 91 (90.1%) reported that they use their inhaler correctly and 80 (79.2%) indicated that using their inhaler is easy. 35 (34.7%) indicated that they prefer to consolidate all of their inhalers. When asked about previous training, 25 (24.8%) reported that they have not been shown how to use inhalers before. Conclusions: Despite high prevalence of poor inhaler technique, COPD patients may not be aware of their poor technique—patients are confident in their use of inhalers and find its use easy. This discrepancy has not been discussed in literature before. Increasing patient awareness regarding poor inhaler technique and the importance of correct use of the device may be the key next step to address poor inhaler technique amongst COPD patients.

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