Division of Pneumology, Morales Meseguer General University Hospital, 30008, Murcia, Spain.
Institute for Bio-health Research of Murcia (IMIB-Arrixaca), El Palmar, 30120, Murcia, Spain.
NPJ Prim Care Respir Med. 2022 Jan 10;32(1):1. doi: 10.1038/s41533-021-00262-8.
To analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% (p = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% (p = 0.009), 25.8% (p = 0.002), 39.2% (p = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment.
分析基于目标导向教学法的教育干预后，COPD 和哮喘患者吸入治疗依从性是否提高。这是一项前瞻性、非随机、单组研究，包括干预前和干预后评估。研究人群包括 120 名（70.8%为女性，53%为男性）被诊断为哮喘（70.8%）和 COPD（29.1%）的患者。通过 Test of the adherence to Inhalers（TAI）来确定依从性水平（低和最佳）和不依从行为模式（不规则、故意和无意识）。该问卷可用于确定依从性水平和不依从的类型。低依从性（LowAd）定义为得分低于 49 分。所有患者均接受个体化教育吸入器技术干预（IEITI）。IEITI 前，67.5%的患者为低依从性。IEITI 后 24 周，低依从性为 55%（p=0.024）。每位患者可能存在一种或多种不依从行为。最常见的类型是忘记使用吸入器（不规则），占 65.8%。其他类型为故意：43.3%，无意识：57.5%。所有类型在最后一次就诊时均减少：51.7%（p=0.009）、25.8%（p=0.002）、39.2%（p=0.002）。研究开始时，哮喘和 COPD 患者的依从性之间无显著差异。唯一预测低依从性的因素是女性性别。在真实世界临床实践条件下，对 COPD 和哮喘门诊患者进行个体化教育干预可提高吸入治疗的依从性。
