What device is highly recommended for use with Pressurised Metered Dose Inhalers (MDIs) to improve lung delivery?

A spacer device

The effectiveness of Pressurized Metered Dose Inhalers (MDIs) is heavily dependent on patient coordination—activating the puff precisely at the start of a slow, deep inhalation. A significant drawback of MDIs used directly is that much of the medication can impact the back of the throat or tongue rather than reaching the lower airways. To overcome this coordination challenge and enhance delivery efficiency, a spacer device is strongly recommended, especially for children or the elderly. This chamber holds the propelled dose after activation, allowing the user to breathe in the medication more slowly and deeply, which can significantly increase the amount of drug reaching the lungs, potentially by up to 70%, while minimizing systemic absorption and local side effects.