Validation of the Italian Version of the Test of Adherence to Inhalers

Abstract

Effective management of asthma requires long-term adherence to inhaled drug therapies [1]. Regular use of maintenance treatment is associated with disease control, reduction in morbidity and costs, and, therefore, improvement in health-related quality of life [2]. Despite these benefits, nonadherence to asthma therapy is still frequent in clinical practice, ranging from 40% to 80% [3]. Although no gold standard exists, the various ways of assessing the level of adherence include laboratory values, pharmacy refill, electronic monitoring, and self-report questionnaires. These approaches are all characterized by strengths and limitations. In clinical practice, there is a need to assess adherence and improve the patient's engagement in shared decision-making and self-management. For a tool to be incorporated into the workflow of routine care, it must be valid, reliable, and inexpensive, as well as short and easy to complete, score, and interpret. Most available self-reported measures of medication have been developed to assess patient's behavior independently of the drug or route of administration [4]. The Test of Adherence to Inhalers (TAI) [5] is the only tool for evaluation of adherence to inhalers that is tailored to patients with chronic obstructive pulmonary disease or asthma. It is composed of 12 items: the first 10 are completed by the patient and evaluate the level of adherence; in the remaining 2, health professionals are asked to detect 2 possible causes of unwitting nonadherent behavior (patient's knowledge of the prescribed regimen and inhaler technique). The questionnaire was originally developed in Spain [5] and is available in many languages. The original Spanish TAI proved to be a valid and reliable instrument [6], and its validity was recently confirmed in Farsi [7]. Here, we describe the psychometric properties of the Italian version of the TAI in terms of validity and reliability [8]. Adult asthmatic patients (≥18 years) in treatment with inhaled therapy for at least 2 months and visiting community pharmacies that employed clinical pharmacy specialists were Manuscript

Suboptimal peak inspiratory flow rate: a noticeable risk factor for inhaler concordance in patients with chronic airway diseases

“…The test of adherence to inhalers (TAI) is a well-accepted and professional instrument for assessing patients' inhaler concordance in chronic airway diseases. 9 Despite its good applicability in European and American populations, [10][11][12] the TAI has not yet been widely used in China. Medication concordance varies tremendously depending on demographic factors, disease-related factors, medication-related factors, etc.…”

“…The test of adherence to inhalers (TAI) is a well-accepted and professional instrument for assessing patients’ inhaler concordance in chronic airway diseases 9. Despite its good applicability in European and American populations,10–12 the TAI has not yet been widely used in China.…”

Exploring Adherence to Treatment in Nasal Polyposis

“…As in other respiratory diseases [3][4], adherence to treatment has been previously explored in CRSwNP, finding low use of INCS and abandonment [5]. Rudmik [8].…”