“…Twenty-five studies of 114 (22%) reported on the effects of gender [ 10 , 30 , 34 , 38 , 40 , 44 , 48 , 53 , 55 , 56 , 59 – 61 , 63 , 65 – 67 , 70 , 73 , 74 , 76 – 80 ], where 6 studies concluded a significant impact on inhaler error frequency, but the results were contradictory and inconclusive as to whether male or female gender was associated with poor technique [ 48 , 53 , 60 , 66 , 79 , 80 ]. Of the 22 studies that reported a trend between low education and high inhaler error frequency [ 10 , 34 , 38 , 44 , 48 , 53 , 56 , 59 – 62 , 64 – 67 , 70 , 73 – 76 , 80 , 81 ], 10 found the association to be statistically significant [ 10 , 34 , 48 , 53 , 56 , 60 , 62 , 66 , 73 , 80 ].…”