Adherence to Inhalation Devices in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) affects millions of people around the world. Poor adherence to treatment contributes to increased severity of symptoms, morbidity, and mortality. The objective of this study was to establish the adherence of patients diagnosed with COPD by their devices for inhalation in a group of patients, Colombia. Patients and Methods: This was a cross-sectional study of patients treated in the Colombian health system. Adherence to inhalation devices was evaluated with the TAI-10 instrument (Inhaler Adherence Test). A score of 50 points was considered good adherence. Results: A total of 500 patients from 84 cities were identified, with a median age of 79.0 years, and 59.2% were women. A total of 45% had GOLD B COPD, and 56.6% had good adherence. Average adherence was 47.4±5.3 points, and no significant differences were found according to inhalation devices (p=0.949). Training performed by specialist physicians (OR: 1.75; 95% CI: 1.17–2.62), use of an inhaler for less than 1 year (OR: 1.59; 95% CI: 1.04–2.43), use of short-acting β2-adrenergic agonists (OR: 1.58; 95% CI: 1.05– 2.38) and increased satisfaction with the inhalation device (OR: 1.09; 95% CI: 1.04–1.14) were associated with good adherence, while those from the central region (OR: 0.55; 95% CI: 0.36–0.83), who had a COPD evolution time of less than 5 years (OR: 0.57; 95% CI: 0.37–0.98) and had diabetes mellitus (OR: 0.60; 95% CI: 0.37–0.98) had lower adherence. Conclusion: Adherence to treatment with inhaled bronchodilators and glucocorticoids were not very high, with no significant differences by type of inhalation device. Satisfaction and training by specialists increased adherence.