title: Impact of patients' satisfaction with their inhalers on treatment compliance and health status in COPD.
abstract: OBJECTIVE
  To examine the relationships between inhaler satisfaction, treatment compliance and health status in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  In a large, multinational, cross-sectional, real-world survey, respiratory specialists and primary care physicians provided information on six consecutive patients with COPD, who were then asked to complete a questionnaire. Physician-assessed compliance was scored (5-point Likert scale) and patients rated overall satisfaction with their maintenance inhaler (7-point Likert scale). Health status assessments included frequency of exacerbations and hospitalizations due to exacerbations in the past 12 months.
  
  
  RESULTS
  The analysis included 1443 patients (71.8% male; mean age 65.2 years). Patients' overall satisfaction with their inhaler was significantly associated with treatment compliance (χ(2) - df = 89.7; p < 0.001). Male gender (χ(2) - df = 2.9; p < 0.05) and fewer maintenance drugs (χ(2) - df = 17.7; p < 0.001) were also associated with compliance; age and breathlessness severity were not. Attributes influencing inhaler satisfaction mainly related to durability, ergonomics and ease of use. Small but statistically significant associations were observed between increasing treatment compliance and fewer exacerbations (R(2) = 0.037; p < 0.001) and fewer hospitalizations due to exacerbations (R(2) = 0.025; p < 0.001). There was a direct association between inhaler satisfaction and fewer exacerbations (R(2) = 0.03; p < 0.001).
  
  
  CONCLUSIONS
  Treatment compliance appears to be modestly associated with inhaler satisfaction, better health status and less frequent COPD exacerbations, although other factors are also likely to be involved. Durability, ergonomics and ease-of-use are inhaler attributes that influence patient satisfaction.
authors.affiliation: Division of Pharmacy and Pharmaceutical Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK. Electronic address: h.chrystyn@hud.ac.uk.
authors.forename: Henry
authors.initials: H
authors.lastname: Chrystyn
authors.affiliation: Adelphi Real World, Adelphi Mill, Grimshaw Lane, Macclesfield SK10 5JB, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Small
authors.affiliation: Adelphi Real World, Adelphi Mill, Grimshaw Lane, Macclesfield SK10 5JB, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: Milligan
authors.affiliation: Adelphi Real World, Adelphi Mill, Grimshaw Lane, Macclesfield SK10 5JB, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Higgins
authors.affiliation: Almirall, Sant Feliu R&D Centre, Laureà-Miró, 408-410, 08980 Sant Feliu de Llobregat, Barcelona, Spain.
authors.forename: Esther Garcia
authors.initials: EG
authors.lastname: Gil
authors.affiliation: Almirall, Ronda General Mitre, 151, 08022 Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Estruch
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009330:Nebulizers and Vaporizers; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D012890:Sleep; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D019819:Budesonide
keywords: Chronic obstructive pulmonary disease (COPD); Compliance; Exacerbations; Inhaler devices; Satisfaction