Adherence to nebulised antibiotics in cystic fibrosis

Abstract

Objective To examine the adherence of patients with cystic fibrosis to nebulised antibiotics. Methods A longitudinal design with adherence data collected over 12 weeks. 38 patients (mean age 24.6 years, S.D. 5.3) were recruited from an adult cystic fibrosis (CF) clinic. Adherence was electronically monitored using a Prodose adaptive aerosol delivery (AAD) device. Results Three indices of adherence were calculated: mean percentage of times the nebuliser was used as prescribed was 50.0% (S.D. = 39.7, range 1.1, 155.6); mean percentage of days fully adhered was 31.6% (S.D. = 29.4, range 0, 97.2); mean percentage of days nebuliser used at least once was 57.1% (S.D. = 34.2, range 3.3, 100). Conclusion Rates of adherence were generally low. Adherence was not associated with any variables apart from age. There were wide variations between individuals, and differences in rates of adherence depending on how this was defined, with potentially important health consequences for the patients. Practice implications Technology that improves medication administration may still be associated with low rates of adherence. Health professionals need to be mindful of the pattern of non-adherence for each individual, and factors which may be influencing this.