Hi. Great question. And I think I can provide you with a good response for your question. I am a respiratory therapist for our local hospital. About five years ago our hospital system switched from offering the spiriva handihaler over to the spiriva respimat. Initially I didn't care for the new inhaler mainly because it was new to me. Although after watching a few videos and learning proper technique I find that it is a very nice inhaler. As a bonus, rather than inhaling a dry powder with the handihaler you are inhaling a nice soft mist with the respimat. I have learned that this "soft mist" is easier to inhale and the theory is that it also gets deeper into your lungs. If you do decide to make the switch it may be a great idea to talk to your pharmacist (or watch an online video) about how to set up and use the inhaler. What do you think? John. copd.net community moderator