Assessing Adherence by Combining the Test of Adherence to Inhalers With Pharmacy Refill Records

Plaza, Vicente; Giner, Jordi; Curto, Elena; Alonso-Ortiz, María Belén; Orue, Miren Itxaso; Vega, José M.; Cosío, Borja G.

doi:10.18176/jiaci.0461

Cited by 30 publications

(40 citation statements)

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“…11,12 Furthermore, adherence to treatment is low, in terms of taking medication and using inhalers correctly, both of which negatively impact treatment outcomes. 13 Each of these factors has cost, effectiveness, and safety implications. For example, a survey including 784 US-based primary care physicians showed highly varied treatment preferences for COPD, and a strong preference for inhaled corticosteroid use, regardless of exacerbation history or knowledge of low lung function, in contravention of GOLD recommendations.…”

Section: Introductionmentioning

confidence: 99%

Advancing the Patient EXperience (APEX) in COPD Registry: Study Design and Strengths

et al. 2021

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The Advancing the Patient Experience (APEX) in Chronic Obstructive Pulmonary Disease (COPD) registry (https:// www.apexcopd.org/) is the first primary care health system-based COPD registry in the United States. While its ultimate goal is to improve the care of patients diagnosed with COPD, the registry is also designed to describe real-life experiences of people with COPD, track key outcomes longitudinally, and assess the effectiveness of interventions. It will retrospectively and prospectively collect information from 3000 patients enrolled in 5 health care organizations. Information will be obtained from electronic health records, and from extended annual and brief questionnaires completed by patients before clinic visits. Core variables to be collected into the APEX COPD registry were agreed on by Delphi consensus and fall into 3 domains: demographics, COPD monitoring, and treatment. Main strengths of the registry include: 1) its size and scope (in terms of patient numbers, geographic spread and use of multiple information sources including patient-reported information); 2) collection of variables which are clinically relevant and practical to collect within primary care; 3) use of electronic data capture systems to ensure high-quality data and minimization of data-entry requirements; 4) inclusion of clinical, database development, management and communication experts; 5) regular sharing of key findings, both at international/national congresses and in peer-reviewed publications; and 6) a robust organizational structure to ensure continuance of the registry, and that research outputs are ethical, relevant and continue to bring value to both patients and physicians.

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Section: Introductionmentioning

confidence: 99%

Advancing the Patient EXperience (APEX) in COPD Registry: Study Design and Strengths

et al. 2021

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“…for pharmacy refill records, versus 64.6% for the combined data, showing that a combined test for adherence identifies a higher number of patients than a single test (25).…”

Section: Discussionmentioning

confidence: 85%

INSPIRO project – Educational intervention against non-adherence to inhalation therapy for Romanian asthma and COPD patients

et al. 2020

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Background In the management of chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), adherence to therapy represents a key to success. Objective The objective was to increase adherence to treatment through the development of educational intervention (EI) for asthma and COPD, addressed to patients and general practitioners (GPs). The educational programme includes group educational sessions and educational materials and was carried out in five Romanian hospitals. The results were assessed through Test of Adherence to Inhalers (TAI) questionnaire. Results Of note, 347 GPs and 435 patients were included. Seventy-six per cent of the GPs considered that the main causes of non-adherence are the disease misunderstanding, difficulty of using inhaled medication, fear of adverse effects, the patient’s conviction that no medicine is useful for his illness and financial nature (20%). Fifty-five per cent of surveyed GPs believed that their patients always or most of the time adhere to inhaled therapy but 57% of the same surveyed GPs checked the inhalation technique of their patients sometimes, rarely or never. Only 44% of the GPs discussed with the pulmonologist about their patient’s disease. Before the EI, only 32% of patients had a good adherence score to therapy; this percentage increases to 57% after EI. The most common reasons for non-adherence were: patient forgets to administer his inhalation medication daily (49%), fear of adverse effects (33%), belief that medication is useless (26%), and fear that inhalation medication affects everyday life of the patient (24%). Nearly half of the patients (47%) give up medication when they feel better. Forty per cent of patients drop off inhalation treatments due to financial reasons. The most influenced behaviours as a result of the EI were psychological component (85%), fear of the adverse events (82%) and social component (79%). Conclusions The non-adherence to therapy remains a real problem in asthma and COPD patients in our study group, but EI had positive effects. Extending medical education programmes for patients focused on main reasons of poor adherence, such as forgetting to take medication daily, use of inhalator devices, not understanding their disease, may significantly increase adherence to inhalation treatment.

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“…For example, the ASCONA study conducted among the asthma patients of Europe reported that almost 60% patients were poor adherent to their prescribed therapy (23). A recent study reported almost 58% poor inhaler adherence rate using the 'TAI' scale, while the rate was 29% using the pharmacy re ll records, which was a more objective scale (24). However, another study from Denmark suggested that self-reported measurements overestimates the adherence rate and might not be used as a reliable indicator (25).…”

Section: Discussionmentioning

confidence: 99%

Adherence to Inhalers and Associated Factors Among Adult Asthma Patients: an Outpatient Based Study in a Tertiary Hospital of Rajshahi, Bangladesh

Rafi¹,

Tahmin²,

Tashrik

et al. 2021

Preprint

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Background: Adherence to inhaler medication is an important contributor of optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence level and to identify the potential factors associated with non-adherence to the inhalers among asthma patients.Methods: This facility-based cross-sectional study was conducted in the medicine outpatient department of Rajshahi Medical College Hospital from November 2020 to January 2021. A total of 357 clinically confirmed adult asthma patients were interviewed. Inhaler adherence was measured using the 10-item Test of Adherence scale (TAI). . Both descriptive and inferential statistics was used to express the socio-demographic of the patients and predictors of poor adherence to inhaler. Results: A substantial number of participants were non-adherent (86%) to inhaler medication. Patient non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67-146.08), lived in rural area ( 23.28, 95% CI 2.43-222.66), less year of schooling (5.69, 95% CI 1.27-25.44), and belonged to the middle income (aOR 9.74, 95% CI 2.11-44.9) than those adherent with inhaler. Presence of comorbidities (12.91, 95% CI 1.41-117.61), prolonged duration of inhaler intake (5.69, 95% CI 1.22-26.49), consulting non-qualified practitioners (13.09, 95% CI 3.10-55.26) were the significant contributor of non-adherence.Conclusion: Despite ongoing motivation and treatment, non-adherence to inhalation anti-asthmatic is high and several factors have been found contributed. Regular monitoring and a guided patient centered self-management approach might be helpful to address the in long run.

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Assessing Adherence by Combining the Test of Adherence to Inhalers With Pharmacy Refill Records

Cited by 30 publications

References 0 publications

Advancing the Patient EXperience (APEX) in COPD Registry: Study Design and Strengths

Advancing the Patient EXperience (APEX) in COPD Registry: Study Design and Strengths

INSPIRO project – Educational intervention against non-adherence to inhalation therapy for Romanian asthma and COPD patients

Adherence to Inhalers and Associated Factors Among Adult Asthma Patients: an Outpatient Based Study in a Tertiary Hospital of Rajshahi, Bangladesh

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