title: The influence of informal caregivers on adherence in COPD patients.
abstract: BACKGROUND
  Contributions of informal caregivers to adherence among chronic obstructive pulmonary disease (COPD) patients remain understudied.
  
  
  OBJECTIVE
  This study aims to evaluate the association between caregiver presence and adherence to medical recommendations among COPD patients.
  
  
  METHODS
  Three hundred and seventy-four COPD patients were asked whether they had a caregiver. Medication adherence was assessed using pharmacy refill data. Smoking status was based on patient self-report. One-way ANOVAs and chi-square analyses were performed controlling for age and number of illnesses.
  
  
  RESULTS
  Compared with the "no caregiver" group, antihypertensive medications adherence was higher in the "spousal caregiver" (0.68 vs. 0.81; 95% CI=0.04 and 0.22) and "non-spousal caregiver" (0.68 vs. 0.80; 95% CI=0.03 and 0.22) groups; long-acting beta agonist adherence was higher in the "spousal caregiver" group (0.60 vs.0.80; 95% CI=0.05 and 0.43). Patients in the "spousal caregiver" group had fewer current smokers compared with the "no caregiver" (χ(2)=16.08; p<0.001) and "non-spousal caregiver" (χ(2)=5.07; p<0.05) groups; those in the "non-spousal caregiver" group reported fewer smokers than the "no caregiver" group (χ(2)=4.54; p<0.05).
  
  
  CONCLUSIONS
  Caregivers, especially spouses, may improve adherence in COPD. Future interventions may target patients without caregivers to optimize COPD management.
authors.affiliation: Northwest Health Services Research and Development (HSR&D) Center of Excellence, VA Puget Sound Health Care System, Seattle, WA, USA. ranak.trivedi@va.gov
authors.forename: Ranak B
authors.initials: RB
authors.lastname: Trivedi
authors.forename: Chris L
authors.initials: CL
authors.lastname: Bryson
authors.forename: Edmunds
authors.initials: E
authors.lastname: Udris
authors.forename: David H
authors.initials: DH
authors.lastname: Au
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012648:Self Care; D057566:Self Report; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents