Fig. 2

The inhaler choice protocol. Solid arrows indicate ‘Yes’ and dotted arrows indicate ‘No’. IN-CHECK^™ (Clement Clarke International Ltd., Harlow, England) was used to evaluate the peak inspiratory flow in Process 2. The pharmacists assessed patient’s physical function subjectively in Process 3. ‘DPI (> pMDI, SMI)’ indicates that DPI should be prioritized over pMDI or SMI unless there is a specific reason otherwise. Aero Chamber^® Plus Flow-Vu^® (Allergan, Inc., Dublin, Ireland) was used as a spacer device

Abbreviations: COPD, chronic obstructive pulmonary disease; DPI, dry powder inhaler; pMDI, pressurized metered-dose inhaler; SMI, soft mist inhaler.