[The validation of checklists for the inhalation technic for the pressurized cartridge and the Turbuhaler]

To determine the intra- and interobserver validity and reliability of two checklists for inhalation technique with a pressurized inhaler (PI) and the Turbuhaler.

Transversal descriptive study performed at an urban health clinic in Gijón (Spain). Thirty-four patients, over 14 years of age but younger than 65, who used a PI and 35 who used a Turbuhaler were chosen randomly from among patients in our health clinic practice. The results obtained with each list by two observers were compared with those obtained by electronic monitors (test pattern). Each patient performed 3 inhalation maneuvers.

Comparison with the test pattern showed that, between 35.2% and 47% of patients used the PI technique correctly, whereas 74.2% inhaled correctly using the Turbuhaler. The sensitivity of the PI checklist ranged from 62.5 to 91.6 and specificity ranged from 88.8 to 94.4. The sensitivity of the Turbuhaler checklist ranged from 50 to 76.9 specificity ranged from 66.6 to 88.8. Intra-observer agreement (Kappa index) was 0.62 to 0.74 for the PI checklist and between 0.77 and 0.81 for the Turbuhaler list. Interobserver agreement (Kappa index) was 0.68 to 0.81 for the PI list and 0.53 to 0.60 for the Turbuhaler list.

The two checklists are valid instruments and offer good intra- and interobserver reliability, permitting easy identification of patients who perform the inhalation technique incorrectly.