Predictors of Treatment Adherence in Outpatients With Chronic Obstructive Pulmonary Disease: Cross-Sectional Study.
Hien Nguyen, Trieu Nguyen, Hoai Nguyen and 3 others
PMID 42789344WHAT IT FOUND
Only 36.9% of COPD outpatients adhered to both inhaled medication and breathing exercises.
Nurses who assess inhaler technique and breathing exercises may identify patients with better knowledge and skills as more likely to adhere.
Key findings
01Only 155 of 420 outpatients were adherent to both inhaled medication and breathing exercises.
02331 of 420 participants had inadequate COPD knowledge, and 152 of 420 failed the practical skills assessment.
03Higher knowledge, passing inhaler-use skills, and passing breathing-exercise skills were associated with higher odds of overall adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that better knowledge or skills caused better adherence. Participants were recruited by convenience sampling. Of 653 patients contacted, 497 agreed and 420 were analysed, and nonparticipants were often older, less healthy, or had transport or family support problems, so the sample may be more stable than usual COPD clinics. Overall adherence required both inhaled medication adherence and correct, daily breathing-exercise practice, so the 36.9% rate may not be comparable with studies that measure medication adherence only. The study did not measure medication affordability, insurance coverage, family support, patient-provider communication, smoking cessation, diet, or physical activity, which may have influenced the observed associations. Data collection happened shortly after pandemic control in Da Nang, which may have affected access to care, follow-up visits, and adherence. Practical skills were judged pass or fail in clinic, and passing does not prove the patient performs the behaviour correctly every day at home.
Declared interests
The authors declared no financial support and no conflicts of interest.
The easy way to misread this
Do not read the higher odds for inhaler and breathing-exercise skills as proof that training patients will raise adherence. The study did not test an intervention and was cross-sectional, so it cannot show cause and effect.