6 Further research
6.1 At present there is insufficient evidence regarding the most clinically and cost effective spacer (e.g. small or large volume). This is reflected in the current lack of standardisation and variations in the usage of these devices. Further research in this area should be carried out in relation to optimising the reproducibility, consistency and acceptability of these delivery systems as well as their overall clinical and cost effectiveness.
6.2 Well conducted community based trials in the management of asthma in young children and studies to investigate factors determining compliance (including health education and the acceptability of devices) in this group of children would enhance the future evidence base.