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And obviously PubMed is kind of your ultimate source for this, but thats a great source, I think, for coaches to recommend to their clients as an educational thing

10.1016/S0165-0270(03)00173-0 [DOI] [PubMed] [Google Scholar] Hosie AM, Dunne EL, Harvey RJ, & Smart TG (2003)

Device satisfaction, HCRU, and exacerbations in real-world patients using GLY/eFlow CS Patient satisfaction and confidence with inhalation devices in COPD are associated with higher treatment compliance, adherence, and better treatment outcomes 45,46

It is important to note that bacterial persistence may also occur in patients, potentially leading to treatment failure

[DOI] [PMC free article] [PubMed] [Google Scholar] 133.Wang J, et al

Rare but Possible Side Effects Although rare, some people may experience stronger L-carnitine side effects, particularly if they have pre-existing medical conditions or take high doses for extended periods