A total of 85 patients using MDI were included in this study. The average age of participants was 44 years and 25% were women. The use of MDI presents a clear difficulty in the simultaneous coordination of respiratory activity and motor movements of the patient with airway obstruction. We found that only 20% of patients were able to perform the inhalation technique correctly as we evaluated the technique by visual observation and included it in the checklist. A total of 68 patients (80%) performed at least one essential step incorrectly. The considerable number of errors regarding inhalation technique observed in our study is in line with previous studies. A study conducted by Buckley D[2] reported that only 18 of 71 patients (25%) had perfect technique, 26 (37%) had adequate technique, and 27 (38%) had poor technique, and patients with Those using a metered-dose inhaler (MDI) were most likely to have poor technique. Study by Molimard et al.[3] also reported similar findings that at least 76% of MDI users made >/ 1 error. In our study, initial training on the use of inhalers was provided predominantly by doctors (55%) followed by qualified nurses (24.70%) and approximately 12% MDI users. patients were taught by a relative or close patient. It was also found that the association between the correctness of the various steps was significantly related to the steps taught by the doctor (Table n.4). Approximately 6% of the patients had learned the technique by themselves with the help of brochures. Only 2% of patients had received initial training from pharmacists. This highlights the diverse spectrum of guides that the patient comes into contact with and also draws attention to the fact that adequate training of healthcare personnel, such as nurses and pharmacists, could help ...... middle of paper . ..... unique and follow-up observation could go a long way in improving patients' inhalation abilities and therefore the effectiveness of treatment. We conclude that substantial errors were made by patients using MDI as an inhalation device. Teaching the correct technique will not only improve patient compliance, but will also lead to better disease control and reduced costs and stress for emergency medical services. Although it is the primary responsibility of the doctor prescribing the inhaler to provide the patient with adequate instructions for using the device, the responsibility could also be branched out within the healthcare team such as pharmacists who could play a vital role in teaching and reinforcing of the technique, as was found in our study. Close follow-up of these patients is necessary and if the patient still has faulty technique, changing the prescription may also be considered.