Background and aims Difficulties and errors in the use of maintenance inhalation devices in COPD are common and can result in loss of control and an increased risk of exacerbations, hospitalisation and death. In this research, participants handled the Breezhaler® (BH) device (Novartis) and the Respimat® (RM) device (Boehringer Ingelheim) assessing each against a number of handling-related device attributes and against each other, to reveal their preferred device. Method 240 maintenance device-naive respondents across Australia, Brazil, Germany and Japan handled each device in a randomised order. Prior to handling the devices, participants ranked 22 handling-related device attributes according to their perception of importance for use. Participants familiarised themselves with the correct handling procedure for each device by consulting relevant ‘Instructions for Use’ and short training videos. After device-handling, participants indicated their level of agreement with pre-defined handling attributes on a 7-point scale from ‘I do not agree at all’ to ‘I completely agree’. In addition and after having handled both devices, participants expressed their preference for one device over the other by splitting 100 points between them. Results Participants perceived BH to be superior to RM on 20 of 22 and similar on 2 of 22 handling-related device attributes (Figure 1). Participants found BH more intuitive to use (69:31), easier to use (60: 40) and offering higher confidence that the full dose has been taken (58:42). Finally, there was a preference for BH over RM (56:44). Conclusions The consistently higher preference for BH regarding device handling-related attributes and its position as the preferred device suggest that it offers an opportunity for improved compliance and therefore improved control of COPD.