Type

Journal Article

Authors

Richard W Costello
Richard B Reilly
Fiona Boland
Frank Doyle
Lisa Mellon
Hannah McCarthy
Mandy Jackson
Brenda Deering
Shahed Tappuni
Philippa MacHale
and 10 others

Subjects

Psychiatry

Topics
observational study patients mild cognitive impairment forced expiratory volume prospective study adherence hierarchical clustering lung function

Objective Assessment of Adherence to Inhalers by COPD Patients. (2016)

Abstract Objective adherence to inhaled therapy by patients with COPD has not been reported. The aim of this study was to objectively quantify adherence to preventer DiskusTM inhaler therapy by patients with COPD with an electronic audio recording device (INCATM). This was a prospective observational study. On discharge from hospital patients were given a salmeterol/fluticasone inhaler with an INCATM device attached. Analysis of this audio quantified the frequency and proficiency of inhaler use. COPD patients (n=265) were recruited. The mean age 71 years, mean Forced Expiratory Volume in 1-second 1.3 Litres, and 80% had evidence of mild/moderate cognitive impairment. By combining time of use, interval between doses and critical technique errors, thus incorporating both intentional and unintentional non-adherence, a measure "Actual Adherence" was calculated. Mean Actual Adherence was 22.9% of that expected if the doses were taken correctly and on time. Seven percent had an Actual Adherence>80%. Hierarchical clustering found three equally sized well-separated clusters corresponding to distinct patterns: Cluster 1 (34%) had low inhaler use and high error rates, Cluster 2 (31%) had high inhaler use and high error rates, and Cluster 3 (30%) had overall good adherence. Lung function and co-morbidities were predictive of poor technique, while age and cognition with poor lung function distinguished those with poor adherence and frequent errors in technique. These data may inform clinicians both in understanding why a prescribed inhaler is not effective and to devise strategies to promote adherence in COPD.
Collections Ireland -> Royal College of Surgeons in Ireland -> PubMed

Full list of authors on original publication

Richard W Costello, Richard B Reilly, Fiona Boland, Frank Doyle, Lisa Mellon, Hannah McCarthy, Mandy Jackson, Brenda Deering, Shahed Tappuni, Philippa MacHale and 10 others

Experts in our system

1
Richard W Costello
Royal College of Surgeons in Ireland
Total Publications: 66
 
2
Richard Reilly
Trinity College Dublin
Total Publications: 185
 
3
Fiona Boland
Royal College of Surgeons in Ireland
Total Publications: 52
 
4
Frank Doyle
Royal College of Surgeons in Ireland
Total Publications: 115
 
5
Lisa Mellon
Royal College of Surgeons in Ireland
Total Publications: 23
 
6
Hannah McCarthy
Royal College of Surgeons in Ireland
Total Publications: 11
 
7
Brenda Deering
Royal College of Surgeons in Ireland