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Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study

BACKGROUND: This study assessed the adherence profiles to inhaled therapies and the agreement between two patient self-report adherence methods in stable COPD lpatients from seven Latin American countries. METHODS: This observational, cross-sectional, multinational, multicenter study involved 795 CO...

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Autores principales: Montes de Oca, Maria, Menezes, Ana, Wehrmeister, Fernando C., Lopez Varela, Maria Victorina, Casas, Alejandro, Ugalde, Luis, Ramirez-Venegas, Alejandra, Mendoza, Laura, López, Ana, Surmont, Filip, Miravitlles, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687703/
https://www.ncbi.nlm.nih.gov/pubmed/29140978
http://dx.doi.org/10.1371/journal.pone.0186777
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author Montes de Oca, Maria
Menezes, Ana
Wehrmeister, Fernando C.
Lopez Varela, Maria Victorina
Casas, Alejandro
Ugalde, Luis
Ramirez-Venegas, Alejandra
Mendoza, Laura
López, Ana
Surmont, Filip
Miravitlles, Marc
author_facet Montes de Oca, Maria
Menezes, Ana
Wehrmeister, Fernando C.
Lopez Varela, Maria Victorina
Casas, Alejandro
Ugalde, Luis
Ramirez-Venegas, Alejandra
Mendoza, Laura
López, Ana
Surmont, Filip
Miravitlles, Marc
author_sort Montes de Oca, Maria
collection PubMed
description BACKGROUND: This study assessed the adherence profiles to inhaled therapies and the agreement between two patient self-report adherence methods in stable COPD lpatients from seven Latin American countries. METHODS: This observational, cross-sectional, multinational, multicenter study involved 795 COPD patients (post-bronchodilator forced expiratory volume in 1 second/forced vital capacity [FEV(1)/FVC] <0.70). Adherence to inhaled therapy was assessed using the specific Test of Adherence to Inhalers (10-item TAI) and the generic 8-item Morisky Medication Adherence Scale (MMAS-8) questionnaires. The percentage agreement and the kappa index were used to compare findings. RESULTS: 59.6% of patients were male (69.5±8.7 years); post-bronchodilator FEV(1) percent predicted was 50.0±18.6%. Mean values for 10-item TAI and MMAS-8 questionnaires were 47.4±4.9 and 6.8±1.6, respectively. Based on the TAI questionnaire, 54.1% of patients had good, 26.5% intermediate, and 19.4% poor adherence. Using the MMAS-8 questionnaire, 51% had high, 29.1% medium, and 19.9% low adherence. According to both questionnaires, patients with poor adherence had lower smoking history, schooling but higher COPD Assessment Test score, exacerbations in the past-year and post-bronchodilator FEV(1). The agreement between 10-item TAI and MMAS-8 questionnaires was moderate (Kappa index: 0.42; agreement: 64.7%). CONCLUSION: Suboptimal adherence to medication was frequent in COPD patients from Latin America. Low adherence was associated with worse health status impairment and more exacerbations. There was inadequate agreement between the two questionnaires. Greater effort should be made to improve COPD patients’ adherence to treatment, and assessment of adherence with more specific instruments, such as the TAI questionnaire, would be more convenient in these patients. CLINICAL TRIAL REGISTRATION: NCT02789540
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spelling pubmed-56877032017-11-30 Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study Montes de Oca, Maria Menezes, Ana Wehrmeister, Fernando C. Lopez Varela, Maria Victorina Casas, Alejandro Ugalde, Luis Ramirez-Venegas, Alejandra Mendoza, Laura López, Ana Surmont, Filip Miravitlles, Marc PLoS One Research Article BACKGROUND: This study assessed the adherence profiles to inhaled therapies and the agreement between two patient self-report adherence methods in stable COPD lpatients from seven Latin American countries. METHODS: This observational, cross-sectional, multinational, multicenter study involved 795 COPD patients (post-bronchodilator forced expiratory volume in 1 second/forced vital capacity [FEV(1)/FVC] <0.70). Adherence to inhaled therapy was assessed using the specific Test of Adherence to Inhalers (10-item TAI) and the generic 8-item Morisky Medication Adherence Scale (MMAS-8) questionnaires. The percentage agreement and the kappa index were used to compare findings. RESULTS: 59.6% of patients were male (69.5±8.7 years); post-bronchodilator FEV(1) percent predicted was 50.0±18.6%. Mean values for 10-item TAI and MMAS-8 questionnaires were 47.4±4.9 and 6.8±1.6, respectively. Based on the TAI questionnaire, 54.1% of patients had good, 26.5% intermediate, and 19.4% poor adherence. Using the MMAS-8 questionnaire, 51% had high, 29.1% medium, and 19.9% low adherence. According to both questionnaires, patients with poor adherence had lower smoking history, schooling but higher COPD Assessment Test score, exacerbations in the past-year and post-bronchodilator FEV(1). The agreement between 10-item TAI and MMAS-8 questionnaires was moderate (Kappa index: 0.42; agreement: 64.7%). CONCLUSION: Suboptimal adherence to medication was frequent in COPD patients from Latin America. Low adherence was associated with worse health status impairment and more exacerbations. There was inadequate agreement between the two questionnaires. Greater effort should be made to improve COPD patients’ adherence to treatment, and assessment of adherence with more specific instruments, such as the TAI questionnaire, would be more convenient in these patients. CLINICAL TRIAL REGISTRATION: NCT02789540 Public Library of Science 2017-11-15 /pmc/articles/PMC5687703/ /pubmed/29140978 http://dx.doi.org/10.1371/journal.pone.0186777 Text en © 2017 Montes de Oca et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Montes de Oca, Maria
Menezes, Ana
Wehrmeister, Fernando C.
Lopez Varela, Maria Victorina
Casas, Alejandro
Ugalde, Luis
Ramirez-Venegas, Alejandra
Mendoza, Laura
López, Ana
Surmont, Filip
Miravitlles, Marc
Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study
title Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study
title_full Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study
title_fullStr Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study
title_full_unstemmed Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study
title_short Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study
title_sort adherence to inhaled therapies of copd patients from seven latin american countries: the lassyc study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687703/
https://www.ncbi.nlm.nih.gov/pubmed/29140978
http://dx.doi.org/10.1371/journal.pone.0186777
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