clinical studies document that many patients use their inhaled medications incorrectly. healthcare provider misuse also has been documented. observation and teaching are essential for patients with chronic lung disease for whom inhaled beta 2 sympathomimetic, anticholinergic, and corticosteroid medications are prescribed.
I am a RT in nursing school......a "spacer" helps alot. Hard to mess it up that way. and btw, MDIs are empty long before they feel empty. a float tells the story. if they go top down, full. top up, empty.