Gomes David Silva, Seixas Carlos, Cravo João
. Departamento de Pneumologia do Hospital Infante D. Pedro, Unidade Local de Saúde da Região de Aveiro, Aveiro, Portugal.
. Portucalense University, Research on Economics, Management and Information Technologies, REMIT, Porto, Portugal.
J Bras Pneumol. 2025 Sep 8;51(3):e20250393. doi: 10.36416/1806-3756/e20250393. eCollection 2025.
This study explores the relationship between inhaler visual identification, naming, and adherence outcomes, and evaluates the potential of combining these factors into a screening tool for identifying poor adherence.
This observational, prospective study included adult patients with COPD, asthma, or asthma+COPD who had been on chronic inhalation therapy for at least the past year. Data were collected through patient interviews and medical records. Adherence was assessed using the Test of Adherence to Inhalers (TAI) questionnaire and prescription records, calculated as the Proportion of Days Covered (PDC). The patients completed a questionnaire to evaluate their ability to visually identify and name their inhalers.
Among the 196 participants, significant differences in adherence levels were observed across the COPD, asthma, and asthma+COPD groups, with COPD patients demonstrating higher adherence rates (p=0.001). Concordance between TAI and PDC was highest in the COPD group (75.0%), compared to the asthma (51.3%) and asthma+COPD (55.5%) groups. Correct naming of inhalers was not significantly correlated with adherence. However, correct inhaler visual identification was associated with better adherence. Incorrect visual identification showed low sensitivity (15.9%) but high specificity (92.6%) for detecting poorly adherent patients.
The ability to visually identify inhalers was associated with better adherence, while the ability to name inhalers was not. Although incorrect visual identification has limited utility as a screening tool, it may still serve as a rapid and practical method for identifying poorly adherent patients in clinical practice.
本研究探讨吸入器视觉识别、命名与依从性结果之间的关系，并评估将这些因素结合成一种用于识别依从性差的筛查工具的潜力。
这项观察性前瞻性研究纳入了患有慢性阻塞性肺疾病（COPD）、哮喘或哮喘合并COPD且过去至少一年一直在接受慢性吸入治疗的成年患者。通过患者访谈和病历收集数据。使用吸入器依从性测试（TAI）问卷和处方记录评估依从性，以覆盖天数比例（PDC）计算。患者完成一份问卷以评估他们视觉识别和说出吸入器名称的能力。
在196名参与者中，COPD、哮喘和哮喘合并COPD组的依从性水平存在显著差异，COPD患者的依从率更高（p = 0.001）。与哮喘组（51.3%）和哮喘合并COPD组（55.5%）相比，TAI与PDC之间的一致性在COPD组中最高（75.0%）。吸入器的正确命名与依从性无显著相关性。然而，正确的吸入器视觉识别与更好的依从性相关。错误的视觉识别在检测依从性差的患者方面显示出低敏感性（15.9%）但高特异性（92.6%）。
吸入器的视觉识别能力与更好的依从性相关，而说出吸入器名称的能力则不然。虽然错误的视觉识别作为一种筛查工具的效用有限，但它仍可能是临床实践中识别依从性差的患者的一种快速实用的方法。
