Effectiveness of individualized inhaler technique training on low adherence (LowAd) in ambulatory patients with COPD and asthma

• Published in: NPJ primary care respiratory medicine Vol. 32; no. 1; p. 1
• Main Authors: Sánchez-Nieto, Juan Miguel, Bernabeu-Mora, Roberto, Fernández-Muñoz, Irene, Carrillo-Alcaraz, Andrés, Alcántara-Fructuoso, Juan, Fernández-Alvarez, Javier, Vera-Olmos, Juan Carlos, Martínez-Ferre, María José, Olea, Mercedes Garci-Varela, Valenciano, Maria José Córcoles, Martínez, Diego Salmerón
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10.01.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/699/1785/31; 692/699/1785/4037; Administration, Inhalation; Asthma; Asthma - epidemiology; Chronic obstructive pulmonary disease; Female; Humans; Inhalers; Internal Medicine; Male; Medication Adherence; Medicine; Medicine & Public Health; Nebulizers and Vaporizers; Noncompliance; Pneumology/Respiratory System; Primary Care Medicine; Prospective Studies; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - epidemiology; Thoracic Surgery
• ISSN: 2055-1010; 2055-1010
• DOI: 10.1038/s41533-021-00262-8

To analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% ( p  = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% ( p  = 0.009), 25.8% ( p  = 0.002), 39.2% ( p  = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment.