Accurate reporting of adherence to inhaled therapies in adults with cystic fibrosis: methods to calculate “normative adherence”

Figures & data

Table 1 Summary of the different adherence values depending on how the medication adherence is reported

Example	Unadjusted adherence (%)	“Simple” normative adherence (without numerator adjustment) (%)	“Sophisticated” normative adherence (without numerator adjustment) (%)	“Simple” normative adherence with numerator adjustment (%)	“Sophisticated” normative adherence with numerator adjustment (%)	Reasons for discrepancy
Person A	27.8	18.5	18.5	18.5	18.5	Under-prescription of inhaled therapy based on Pseudomonas status
Person B	61.1	61.1	20.4	61.1	20.4	Under-prescription of inhaled therapy based on previous intravenous antibiotic requirement
Person C	64.5	64.5	64.5	58.2	58.2	Brief period of nebulizer overuse resulted in slightly exaggerated unadjusted adherence figure

Figure S1 The required maintenance inhaled therapy based on a range of prognostic factors used to decide the minimum denominator for the “extended sophisticated” normative adherence.

Notes: ^ψPseudomonas status as defined by the Leeds definition.¹⁶ People with intermittent Pseudomonas should be on inhaled antibiotics in addition to inhaled mucolytic for 1 month or 3 months depending on the antibiotic regime when Pseudomonas is newly detected. ^ΩGenotype status as defined by international consensus.⁵ “Mild genotype” is defined by the presence of at least one class IV–V CFTR mutation.

Abbreviations: CFTR, cystic fibrosis transmembrane conductance regulator; FEV₁, forced expiratory volume in 1 second; IV, intravenous.