“In view of the many advantages and few disadvantages of spacers/VHCs, every patient treated with a pMDI should own and regularly use a spacer/VHC, and know how to use it properly, both for routine preventer therapy and in an emergency, and how to keep it clean and keep an eye out for faults.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004521/

@Nathan Pounds - Thanks for sharing this article! Using a spacer correctly and cleaning it regularly is important! Here is a video for Tips for Improving Your Inhaler Technique . When cleaning a spacer, it's important to use water and a detergent. Cleaning your spacer with only water causes an electrostatic charge. This affects how much medicine sticks on the inside of the spacer.