Moran Catherine, Doyle Frank, Sulaiman Imran, Bennett Kathleen, Greene Garrett, Molloy Gerard J, Reilly Richard B, Costello Richard W, Mellon Lisa
a Department of Psychology, Division of Population Sciences , Royal College of Surgeons in Ireland , Dublin , Ireland.
b Department of Respiratory Medicine , Royal College of Surgeons in Ireland , Dublin , Ireland.
Psychol Health. 2017 Oct;32(10):1266-1287. doi: 10.1080/08870446.2017.1290243. Epub 2017 Feb 28.
To compare the Inhaler Compliance Assessment (INCA), a novel audio-recording device objectively measuring timing and proficiency of inhaler use, against established adherence measures, and explore its discriminant and predictive validity.
Prospective observational study; 184 chronic obstructive pulmonary disease (COPD) patients used an INCA-enabled salmeterol/fluticasone inhaler for one-month post-hospital discharge.
INCA (Attempted, Attempted Interval, Actual) adherence correlated with Doses Used Rate, self-reported adherence and prescription refill for concurrent validity. Discriminant validity for reason for admission, cognition and lung function; predictive validity for health status and quality-of-life.
Rates of Attempted, Attempted Interval and Actual adherence were 59, 47 and 23%, respectively. Only 7% of participants had Actual adherence >80%. INCA variables significantly correlated with Doses Used Rate but not with self-report; Attempted and Attempted Interval were weakly associated with prescription refill. Higher cognitive and lung functioning groups had better INCA adherence. Attempted and Attempted Interval predicted health status, while Doses Used Rate predicted quality-of-life.
INCA did not strongly correlate with self-report or prescription refill data. Discriminant and predictive validity demonstrated by INCA suggests the potential utility of the INCA as a method to identify intentional and unintentional adherence to inhaled medication and facilitate targeted intervention.
比较吸入器依从性评估（INCA）这一客观测量吸入器使用时间和熟练程度的新型音频记录设备与既定的依从性测量方法，并探讨其判别效度和预测效度。
前瞻性观察性研究；184例慢性阻塞性肺疾病（COPD）患者出院后使用配备INCA的沙美特罗/氟替卡松吸入器一个月。
INCA（尝试次数、尝试间隔、实际使用情况）依从性与用药剂量率、自我报告的依从性以及同时期的处方 refill 相关，以评估同时效度。入院原因、认知和肺功能的判别效度；健康状况和生活质量的预测效度。
尝试次数、尝试间隔和实际使用情况的依从率分别为59%、47%和23%。只有7%的参与者实际使用情况依从率>80%。INCA变量与用药剂量率显著相关，但与自我报告无关；尝试次数和尝试间隔与处方 refill 弱相关。认知和肺功能较高的组INCA依从性较好。尝试次数和尝试间隔可预测健康状况，而用药剂量率可预测生活质量。
INCA与自我报告或处方 refill 数据的相关性不强。INCA显示的判别效度和预测效度表明，INCA作为一种识别吸入药物有意和无意依从性并促进针对性干预的方法具有潜在效用。
