On day 1 only three patients (8%) had inadequate technique for LVS vs. 12 (30%) for MDI (X2 = 6.90; p = 0.032). The main problems were inability to trigger the device (two patients with both devices), problems co-ordinating triggering and inhalation (20 patients with MDI), problems inserting the MDI into the LVS (seven patients), and unnecessary repetitive firing of the LVS (three patients); 28 (70%) preferred LVSs. On day 29, 29/30 (97%) with LVSs used them adequately, as did 13/15 (87%) using MDIs (five patients used both).
LVSs have advantages over MDIs for elderly patients in terms of patient preference and inhaler technique.