Abstract
Sub-optimal chronic obstructive pulmonary disease (COPD) management has been found largely due to patients’ medication non-adherence and incorrect inhaler technique. This study aimed to examine inhaler use technique and medication adherence among Vietnamese COPD patients as well as potential associated factors. A cross-sectional study involving 70 COPD exacerbators was conducted. Inhaler technique and adherence were evaluated by the 10-item and 12-item Test of Adherence to Inhaler (TAI). Data on the history of COPD, home prescription of inhalers and duration of hospitalization were also collected. Generalized linear regression models were used to determine the associated factors with inhaler use and medication adherence. The results showed that the proportion of patients with good inhaler technique was 22.7% for metered-dose inhalers (MDI), 30.4% for dry powder inhalers (DPI) and 31.8% for soft-mist inhalers (SMI). Full exhalation was the most common mistake. The rates of non-compliance patterns were: “ignorant” (77.1%), “sporadic” (58.6%), and “deliberate” (55.7%). Worse dyspnea, greater health condition impairment, and an increased frequency of exacerbations and hospitalizations were found to be associated negatively with correct inhaler use and treatment adherence. Instructions to COPD patients about using inhalers should focus on correct inhaler technique and adherence even when feeling healthy.
Highlights
Chronic obstructive pulmonary disease (COPD) has been considered a significant global health issue, with increasing prevalence causing a substantial burden of disease for those infected and on society [1]
A number of studies have indicated that such chronic obstructive pulmonary disease (COPD) management strategies have not succeeded in providing optimal efficiency, with medication non-adherence and incorrect inhaler technique found in patients being cited as the main reasons [4,6,7]
This study aimed to examine the current situation regarding inhaler use technique and adherence in a cohort of COPD patients in Vietnam as well as factors potentially influencing such use, with a hope to identify implications and improve medication effectiveness
Summary
Chronic obstructive pulmonary disease (COPD) has been considered a significant global health issue, with increasing prevalence causing a substantial burden of disease for those infected and on society [1]. The growth of the prevalence and burden of COPD has been predicted to be on the rise, as a result of the hardly changing popularity of smoking, increasing air pollution and general aging of the world population [2]. Recommended strategies for COPD management commonly involve the use of inhaled medication [4]. A number of studies have indicated that such COPD management strategies have not succeeded in providing optimal efficiency, with medication non-adherence and incorrect inhaler technique found in patients being cited as the main reasons [4,6,7]. Understanding the barriers to optimal inhaler use among patients as well as determining solutions to overcome these obstacles can be said to be essential to enhancing the effectiveness of COPD treatment
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