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A 68-year-old man has been diagnosed with moderate chronic obstructive pulmonary disease (COPD) (FEV1: 56% of predicted.) He has been taking his salbutamol and ipratropium bromide inhalers 4 times daily as directed. He now returns to clinic with complaints lack of improvement in his shortness of breath.

Which one of the following is most important to enquire about before adding or changing his present medications?


a- Presence of a cat in the house
b- Use of an aerochamber with his inhalers
c- Level of exercise tolerance
d- Production of sputum
e-taking his medications at regular times
e-taking his medications at regular times ?