COPD patient who is on Tiotropium Respimart and other inhalers continued.~Those fullfill inclusion criteria will be randomized into two group.~To do Baseline CAT score and SGRQ questionnaires with Lung function test.~Assess inhaler technique with and without aerochamber.~Teach proper inhaler technique by templates and demonstrate to patients.~Group A given aerochamber and Group B without aerochamber enroll in the study for total 18 week .~First phase for 8 week after that 2 week of washout periode (without aerochamber both arm).~Then Group A without aerochamber and Group B with aerochamber continue with all inhalers for 8 week.~Followed up at 8th , 11th and 18th week to assess inhaler techniques ,Lung function test and do CAT score, and SGRQ questionnaire.~Analysis data
COPD patient on Tiotropium Respimart divided into two group, Group A given aerochamber and Group B without aerochamber enroll in the study for total 18 week .