Determinants of self-reported adherence to inhaler therapy in patients with chronic obstructive pulmonary disease

Autor:	Ilaria Aredano, Francesca De Blasio, Paola Berchialla, Luisa Brussino, Caterina Bucca, Paolo Solidoro
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Pulmonary and Respiratory Medicine 03 medical and health sciences 0302 clinical medicine inhaler therapy 030228 respiratory system therapy adherence COPD lung function 030212 general & internal medicine Original Research Article Retraction
Zdroj:	Multidisciplinary Respiratory Medicine
ISSN:	2049-6958 1828-695X
Popis:	Background Adherence to therapy is crucial for COPD patients, since non-adherence leads to worse quality of life, increased health-care expenditure and poor clinical outcome. The aim of this study was to identify the main determinants of suboptimal adherence to therapy in a cohort of COPD patients. Methods General information (age, BMI, smoking, comorbidities, education, life style), lung function, exacerbations, symptoms and COPD treatment were collected. Adherence to therapy was assessed by self-reported 4-item Morisky Medication Adherence Scale (MMAS-4), and was related to anthropometric, socio/economic and health status data, obtained by questionnaires (COPD Assessment Test, CAT; Treatment Satisfaction Questionnaire, HRQoL; Katz Index of Independence of Daily Living Activities, Lawton Instrumental Activities of Daily Living Scale). Results 136 COPD patients were studied (age 72±8 yrs; 73.5% men; BMI 28.5±7.4 kg/m2; FEV1 53.5±19.0 % predicted). Nearly half of the patients (46.3%) had suboptimal adherence to therapy (score >0) and, as compared to those with optimal adherence, had higher prevalence of women and coronary artery disease, heavier smoking history and worse CCQ overall score. The results of multivariate analysis showed that the determinants of suboptimal adherence were female sex (OR 4.339, 95%CI 1.509-12.474, p=0.006), amount of pack/years smoked (OR 1.947, 95%CI 1.141-3.323, p=0.015), higher CCQ overall score (OR 3.318, 95%CI 1.050-9.892, p=0.049) and higher education (OR 2.758, 95%CI 1.083-7.022, p=0.033). Adherence was better in patients assuming triple inhaler therapy. Conclusions Suboptimal adherence is frequent among COPD patients, particularly in women, heavy smokers and subjects with high educational level. Interventions to improve adherence should be especially addressed to patients with these characteristics.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e5c7f00f066d3a300c983e0ebe97dae http://europepmc.org/articles/PMC7205009 Zobrazit plný text záznamu