Plaza Vicente, López-Viña Antolín, Entrenas Luis Manuel, Fernández-Rodríguez Concepción, Melero Carlos, Pérez-Llano Luis, Gutiérrez-Pereyra Fernando, Tarragona Eduard, Palomino Rosa, Cosio Borja G
a Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau , Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine , Barcelona , Spain.
b Pulmonology Department, Hospital Universitario Puerta de Hierro , Majadahonda , Madrid , Spain.
COPD. 2016 Oct;13(5):547-54. doi: 10.3109/15412555.2015.1118449. Epub 2016 Jan 20.
Differences between COPD and asthma may also differentially affect adherence to inhaled drugs in each disease. We aimed to determine differences in behaviour patterns of adherence and non-adherence to inhaled therapy between patients with COPD and patients with asthma using the Test of Adherence to Inhalers (TAI) questionnaire. A total of 910 patients (55% with asthma, 45% with COPD) participated in a cross-sectional multicentre study. Data recorded included sociodemographics, education level, asthma or COPD history, TAI score, the Asthma Control Test (ACT), the COPD Assessment Test (CAT) and spirometry. Asthma patients were statistically significant less adherents, 140 (28%) vs. 201 (49%), and the pattern of non-adherence was more frequently erratic (66.8% vs. 47.8%) and deliberate (47.2% vs. 34.1%) than COPD patients; however unwitting non-adherence was more frequently observed in COPD group (31.2% vs. 22.8%). Moreover, taking together all sample studied, only being younger than 50 years of age (OR 1.88 [95% CI: 1.26-2.81]) and active working status (OR 1.45 [95% CI: 1.00-2.09]) were risk factors for non-adherence in the multivariate analysis, while having asthma remained in the limits of the significance (OR 1.44 [95%CI: 0.97-2.14]). Even though non-adherence to inhalers is more frequently observed in asthma than in COPD patients and exhibited a different non-adherence patterns, these differences are more likely to be related to sociodemographic characteristics. However, differences in non-adherence patterns should be considered when designing specific education programmes tailored to each disease.
慢性阻塞性肺疾病（COPD）和哮喘之间的差异也可能对每种疾病中吸入药物的依从性产生不同影响。我们旨在通过吸入器依从性测试（TAI）问卷来确定COPD患者和哮喘患者在吸入治疗依从性和不依从性行为模式上的差异。共有910名患者（55%为哮喘患者，45%为COPD患者）参与了一项横断面多中心研究。记录的数据包括社会人口统计学、教育水平、哮喘或COPD病史、TAI评分、哮喘控制测试（ACT）、COPD评估测试（CAT）和肺功能测定。哮喘患者的依从性在统计学上显著较低，为140例（28%），而COPD患者为201例（49%），且不依从模式比COPD患者更频繁地表现为不稳定（66.8%对47.8%）和故意不依从（47.2%对34.1%）；然而，无意中的不依从在COPD组中更频繁地观察到（31.2%对22.8%）。此外，综合所有研究样本，在多变量分析中，只有年龄小于50岁（比值比[OR]1.88[95%置信区间：1.26 - 2.81]）和在职状态（OR 1.45[95%置信区间：1.00 - 2.09]）是不依从的危险因素，而患有哮喘仍在显著性界限内（OR 1.44[95%置信区间：0.97 - 2.14]）。尽管哮喘患者中吸入器不依从比COPD患者更常见，且表现出不同的不依从模式，但这些差异更可能与社会人口统计学特征有关。然而，在设计针对每种疾病的特定教育项目时，应考虑不依从模式的差异。
