Predictors of patient adherence to long-term home nebulizer therapy for COPD. The IPPB Study Group. Intermittent Positive Pressure Breathing.
OBJECTIVE
Patients with moderate to severe COPD are frequently prescribed expensive and complicated therapies that require adjustments in usual activities of daily living. However, little is known about factors that are associated with adherence to such treatment. The objective of this study was to identify characteristics of patients who were adherent to long-term home nebulizer therapy.


METHODS
Patients were stratified into two adherence groups based on average minutes of nebulizer use each day. A logistic regression model was developed to predict adherence based on baseline variables. A questionnaire was administered to patients to assess reasons for adherence to therapy.


METHODS
Five clinical centers in the United States and Canada.


METHODS
Nine hundred eighty-five patients with moderate to severe COPD enrolled in the Intermittent Positive Pressure Breathing (IPPB) Trial.


METHODS
Long-term home IPPB and nebulizer therapy.


RESULTS
Altogether 50.6% of patients were adherent, and 49.4% were nonadherent. Among baseline variables, good adherence was predicted by white race, married status, abstinence from cigarettes and alcohol, serum theophylline level > or = 9 micrograms/mL, more severe dyspnea, and reduced FEV1 (p < 0.05). Subjects who were adherent to nebulizer therapy were older, better educated, had a stable lifestyle, were more likely to report that the therapy made them feel better, and were more likely to keep clinic appointments.


CONCLUSIONS
Sociodemographic, physiologic, and quality of life variables were associated with adherence to long-term nebulizer therapy.
Turner
J
J
New England Research Institute, USA.
Wright
E
E
Mendella
L
L
Anthonisen
N
N
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D007384:Intermittent Positive-Pressure Breathing / Q000295:instrumentation / Q000706:statistics & numerical data; D016015:Logistic Models; D008134:Long-Term Care / Q000706:statistics & numerical data; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data; D010349:Patient Compliance; D011379:Prognosis; D011788:Quality of Life; D012372:ROC Curve; D012680:Sensitivity and Specificity