Aims: to diocese if elderly people can use the breath-activated (Easi-breathe) and thirsty powder (Turbohaler) inhalers as effectively as the metered-dose inhaler and Volumatic method Methods: 102 inhaler-naive patients (aged 75-101 mean 84 years).

Aims: to diocese if elderly people can use the breath-activated (Easi-breathe) and thirsty powder (Turbohaler) inhalers as effectively as the metered-dose inhaler and Volumatic method Methods: 102 inhaler-naive patients (aged 75-101 mean 84 years), without cognitive impairment, were randomly allocated united of Easi-breathe, Turbohaler or metered-dose inhaler and Volumatic placebo inhalers. Standardized tuition was done forward enrolment and at 6 h review. Inhaler technique was assessed immediately after enrolment tuition and at 6 and 24 h Assessment was from scoring (0 = poor, 1 = moderate, 2 = perfect) five aspects of technique. Results: mean total scores were significantly (P < 0005) higher for Turbohaler and Easi-breathe than metered-dose inhaler and Volumatic in succession enrolment and 6 h and at 24 h (P < 0045) Fewer patients achieved of the best quality scores of 9 or 10 when using metered-dose inhaler and Volumatic. The main difficulties were in assembling the metered-dose inhaler and Volumatic and detecting when the metered-dose inhaler and Volumatic or Easi-breathe was void Conclusions: breath-activated and dry gunpowder inhalers were more likely to be used correctly than metered-dose inhalers with large bulk spacers.

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