Abstract
BackgroundCorrect inhaler use can be challenging in real life, with incorrect use resulting in poor symptom control. The aim of this study was to examine factors associated with poor inhaler technique and poor therapy adherence among patients with obstructive lung disease in community pharmacies.MethodsA cross-sectional study was conducted in patients with obstructive lung diseases in nine Belgian community pharmacies. Logistic regression analyses identified factors associated with poor inhaler technique and poor therapy adherence (assessed by the Test of Adherence to Inhalers and the modified Medication Possession Ratio).ResultsSeventy obstructively impaired community patients (median age 64 y, 56% females) were included and the technique of 122 inhalers was assessed. Inhaler technique scored generally poor, with half of patients making critical errors in using at least one of their inhalers. In multivariable analysis, the use of multiple devices (adjusted OR, aOR 11.68; 95% CI 3.29 to 41.51) and a diagnosis of asthma-Chronic Obstructive Pulmonary Disease overlap (ACO; aOR 7.06; 95% CI 1.15 to 43.35), were associated with making critical errors in inhaler technique independent of quality of life. Non-adherence occurred in more than one-third of patients, and occurred in up to one half of the patients when also taking overuse into account. In multivariable analysis for therapy adherence, current smoking was associated with poor therapy adherence (aOR 0.15; 95% CI 0.02 to 0.96) independently of age and poor treatment knowledge. Therapy adherence was poor in patients with asthma compared with those with ACO. Current smokers and highly educated patients seemed to be at increased risk for inhaler overuse.ConclusionsGiven the important role of a correct inhaler technique and therapy adherence in disease control, these findings emphasise the need for patient education and aiming uniformity in the inhaler device.Trial registration numberB670201835229.
Funder
Belgian Respiratory Society
Subject
Pulmonary and Respiratory Medicine
Reference38 articles.
1. World Health Organization . Chronic respiratory diseases, 2017. Available: https://www.who.int/respiratory/en/
2. Global Initiative for Chronic Obstructive Lung Disease . Global strategy for the diagnosis, management and prevention of COPD: 2020 report., 2020. Available: https://goldcopd.org/wp-content/uploads/2019/11/GOLD-2020-REPORT-ver1.0wms.pdf
3. Global initiative for asthma . Global strategy for asthma managment and prevention., 2020. Available: https://ginasthma.org/wp-content/uploads/2020/06/GINA-2020-report_20_06_04-1-wms.pdf
4. Inhaler technique: facts and fantasies. A view from the aerosol drug management improvement team (admit);Levy;NPJ Prim Care Respir Med,2016
5. Inhaled corticosteroids and the occurrence of oral candidiasis: a prescription sequence symmetry analysis;van Boven;Drug Saf,2013
Cited by
18 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献