Correlation Analysis of the Therapy Adherence to Long-Acting Inhalers Among Patients with Stable COPD

Figures & data

Figure 1 Flow of participants through the study.

Table 1 Demographic Features of the Adherence in Patients with Stable COPD

Characteristic	n (%)	Good Adherence (n=93)	Poor Adherence (n=153)	t/Z	p-value
Male	202 (82.1%)	81(87.10%)	121(79.08%)	2.53	0.11
Age
≥ 65 years old	186 (75.6%)	71(76.34%)	115(75.16%)	0.04	0.83
42–65years old	60 (24.4%)	22(23.66%)	38(24.84%)
Weight (kg)	59.17±10.05	59.51±9.73	58.96±10.26	0.89	0.35
Education background
Junior high school or below	196 (79.7%)	67(72.0%)	129(84.3%)	5.38	0.02
High school or above	50 (20.3%)	26(28.0%)	24(15.7%)
Household income monthly (yuan)
<3000 yuan	188 (76.4%)	65(69.90%)	123(80.4%)	3.54	0.06
>3000 yuan	58 (23.6%)	28(30.1%)	30(19.6%)
Personal history
Smoking history	145 (58.9%)	59(79.57%)	86(62.50%)	1.25	0.26
Drinking history	14 (5.7%)	5(5.38%)	9(5.88%)	0.03	0.87
Comorbidities
Hypertension	89 (36.2%)	33(36.89%)	56(35.71%)	0.03	0.86
Coronary heart disease	105 (42.7%)	40(43.01%)	65(42.48%)	0.01	0.94
Cerebral vascular disease	23 (9.3%)	9(9.68%)	14(9.15%)	0.02	0.89
Diabetes	26 (10.6%)	7(7.53%)	19(12.42%)	1.46	0.23
Chronic gastritis	48 (19.5%)	23(24.73%)	25(16.34%)	2.60	0.18
COPD history
Course of disease	7.85±6.59	6.63±2.26	8.69±3.81	3.62	0.02
≥2 moderate or severe exacerbation past year	181(73.6%)	61(65.59%)	120(78.43%)	4.91	0.03
Severity of airflow obstruction
Moderate	50(20.3%)	27(29.03%)	23(15.03%)	7.04	0.03
Severe	156(63.4%)	52(55.91%)	104(67.97%)
Very severe	40(16.3%)	14(15.05%)	26(16.99%)
Number of varieties of inhalers used successively
<2	168 (68.3%)	57(62.29%)	111(72.55%)	3.39	0.07
≥ 2	78 (21.7%)	36(38.71%)	42(27.45%)

Abbreviations: Z, Kolmogorov–Smirnov Z; t, t-test.

Table 2 The Adherence of Patients Who Inhaled Different Drugs in ICS/LABA

Inhalant	Total Cases	Good Adherence	Poor Adherence	OR (95% CI)	p-value
Budesonide and Formoterol Fumarate	75	26(34.67%)	49(65.33%)	1.12 (0.58–2.14)	0.74
Salmeterol Xinafoate and Fluticasone Propionate	90	29(32.22%)	61(67.78%)

Abbreviation: ICS/LABA, inhaled corticosteroids/long-acting beta-adrenoceptor agonists.

Table 3 The Adherence of Patients Who Inhaled Different Drugs in LAMA

Inhalant	Total Cases	Good Adherence	Poor Adherence	OR (95% CI)	p-value
Tiotropium Bromide powder spray	59	23(38.98%)	36(61.02%)	0.33 (0.12–0.95)	0.04
Tiotropium Bromide spray	22	15(68.18%)	7(31.82%)

Abbreviation: LAMA, long-acting muscarinic antagonists.

Figure 2 The comparison of different types of inhalers in patients with COPD. *p < 0.05.

Table 4 The Percentage of Patients’ Engagements in Each Action of Adherence and the Mean Score for Each Item*

MARS Item	Always n (%)	Often n (%)	Sometimes n (%)	Rarely n (%)	Never n (%)	Mean (SD)	Median (IQR)
I only use it when I need it	13(8.5%)	57(37.3%)	44(28.8%)	33(21.6%)	6(3.9%)	3.25(1.01)	3(2)
I only use it when I feel breathless	30(19.6%)	52(34.0%)	37(24.2%)	29(19.0%)	5(3.3%)	3.48(1.11)	4(1)
I decide to miss out a dose	21(13.7%)	50(32.7%)	53(34.6%)	25(16.3%)	4(2.6%)	3.39(1.00)	3(1)
I try to avoid using it	30(19.6%)	41(26.8%)	53(34.6%)	26(17.0%)	3(2.0%)	3.45(1.05)	3(1)
I forget to take it	13(8.5%)	39(25.5%)	75(49.0%)	25(16.3%)	1(0.7%)	3.25(0.85)	3(1)
I alter the dose	23(15.0%)	57(37.3%)	48(31.4%)	22(14.4%)	3(2.0%)	3.49(0.98)	4(1)
I stop taking it for a while	18(11.8%)	40(26.1%)	56(36.6%)	29(19.0%)	10(6.5%)	3.18(1.08)	3(2)
I use it as a reserve, if my other treatment does not work	48(31.4%)	37(24.2%)	38(24.8%)	27(17.6%)	3(2.0%)	3.65(1.15)	4(2)
I use it before doing something which might make me breathless	78(51.0%)	37(24.2%)	27(17.6%)	10(6.5%)	1(0.7%)	4.18(0.99)	5(1.5)
I take it less than instructed	16(10.5%)	43(28.1%)	59(38.6%)	27(17.6%)	8(5.2%)	3.21(1.02)	3(1)
MARS-Score	Good adherence (Score≥4.5)					4.81(0.16)	4.90(0.20)
	Poor adherence (Score<4.5)					3.45(0.62)	3.49(0.92)
	Overall					3.97(0.83)	4.05(1.40)

Notes: *Items score, 5=Never, 4=Rarely, 3=Sometimes, 2=Often, 1=Always.

Abbreviation: MARS, Medication Adherence Report Scale.