Table 2: Choice of inhaler devices according to the patient’s inspiratory flow and ability to coordinate inhaler actuation and inhalation. Modified from Chapman et al. [90].

Good hand-lung coordinationPoor hand-lung coordination
Inspiratory flow > 30 L/minInspiratory flow < 30 L/minInspiratory flow > 30 L/minInspiratory flow < 30 L/min

pMDIpMDIpMDI + spacerpMDI + spacer
BAMDINebuliserBAMDINebuliser
DPISMIDPISMI
NebuliserNebuliser
SMISMI

pMDI: pressurised metered-dose inhalers; BAMDI: breath-actuated metered-dose inhaler; DPI: dry powder inhaler; SMI: soft mist inhaler.