title: Relationships between repeated instruction on inhalation therapy, medication adherence, and health status in chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Adherence to inhalation therapy is a critical determinant of the success of chronic obstructive pulmonary disease (COPD) management. However, in practice, nonadherence to inhalation therapy is very common in COPD patients. The effects of adherence to inhalation therapy in COPD have not been fully studied, and less is known about the relationship between medication adherence and quality of life in COPD. Our aim is to assess the factors that contribute to adherence to inhalation therapy and examine their correlation with quality of life.
  
  
  METHODS
  A cross-sectional analysis of 88 COPD patients was performed using a self-reported adherence questionnaire with responses on a 5-point Likert scale.
  
  
  RESULTS
  Of the 88 patients who were potential participants, 55 (63%) responded with usable information. The only significant factor associated with the overall mean adherence score was receiving repeated instruction about inhalation techniques (P = 0.032). Of the 55 respondents, 22 (40.0%) were given repeated verbal instruction and/or demonstrations of inhalation technique by a respiratory physician. Significant correlations were found between the overall mean adherence score and the health-related quality of life score (St George's Respiratory Questionnaire: total, r = -0.35, P = 0.023; symptoms, r = -0.43, P = 0.002; impacts, r = -0.35, P = 0.011). Furthermore, patients with repeated instruction showed better quality of life scores than those who did not receive instruction (total, P = 0.030; symptoms, P = 0.038; impacts, P = 0.019).
  
  
  CONCLUSIONS
  Repeated instruction for inhalation techniques may contribute to adherence to therapeutic regimens, which relates to better health status in COPD.
authors.affiliation: Division of Respiratory Medicine, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Osaka, Japan. m-takemura@kitano-hp.or.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Takemura
authors.forename: Katsumi
authors.initials: K
authors.lastname: Mitsui
authors.forename: Ryo
authors.initials: R
authors.lastname: Itotani
authors.forename: Manabu
authors.initials: M
authors.lastname: Ishitoko
authors.forename: Shinko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Kensaku
authors.initials: K
authors.lastname: Aihara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Oguma
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ueda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kagioka
authors.forename: Motonari
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007564:Japan; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents