title: External validation of the recommendations of the multidisciplinary consensus about inhaled therapies.
abstract: The understanding of physicians and the skill of patients in the use of inhalers continues to be inadequate.
  
  
  OBJECTIVE
  The external validation, by an expert panel, of practical clinical recommendations that had been developed in order to improve the knowledge and understanding of correct inhaled therapy use.
  
  
  METHODS
  After a bibliographic review about inhaled therapies, 40 clinical recommendations were proposed. A two-round modified Delphi consensus was used to compare the opinions of a panel of 59 experts about the recommendations, which were grouped into 8 areas: general aspects (4), inhaled drugs (9), pressurized metered-dose and spacer inhalers (6), powder inhalers (4), nebulizers (3), devices for mechanical ventilation (3), inhalers for children (5) and issues related with compliance and education (6).
  
  
  RESULTS
  After the first round of the consensus panel, 35 of the 40 recommendations analyzed were accepted. At the end of round 2, agreement was reached in 39 (97.5%). In 8 (20%), the consensus was unanimous (100%). Item 14 was deleted from the recommendations as consensus was not reached.
  
  
  CONCLUSIONS
  The external validation by experts in inhaled therapy found a high level of agreement with the clinical recommendations proposed. This consensus provides a tool that could contribute to the improved use of inhalers in our country in the future.
authors.affiliation: Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, España. vplaza@santpau.cat
authors.forename: Vicente
authors.initials: V
authors.lastname: Plaza
authors.forename: Myriam
authors.initials: M
authors.lastname: Calle
authors.forename: Jesús
authors.initials: J
authors.lastname: Molina
authors.forename: Santiago
authors.initials: S
authors.lastname: Quirce
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sanchis
authors.forename: José Luis
authors.initials: JL
authors.lastname: Viejo
authors.forename: Fernando
authors.initials: F
authors.lastname: Caballero
mesh_terms: D003697:Delphi Technique; D006801:Humans; D017410:Practice Guidelines as Topic; D012138:Respiratory Therapy / Q000592:standards*