title: Factors affecting nebulised medicine adherence in adult patients with cystic fibrosis: a qualitative study.
abstract: BACKGROUND
  Nebulised medicines contribute to the high treatment burden experienced by patients with cystic fibrosis (CF).
  
  
  OBJECTIVE
  This study explored experiences of adult patients with CF when using nebulised medicines, factors impacting on their adherence to nebulised therapy and strategies they used to facilitate adherence.
  
  
  METHODS
  Community setting, in Sydney, Australia.
  
  
  METHODS
  Ten patients with CF were recruited through a CF patient organisation. Semi-structured face-to-face interviews were conducted, addressing the study objectives. Interviews were audio-recorded, transcribed verbatim and content analysed for anticipated and emergent themes.
  
  
  METHODS
  Experiences with using nebulised medicines; and barriers and facilitators of adherence to nebulised medicines.
  
  
  RESULTS
  Participants' age ranged from 22 to 45 years, with half being male. Four broad themes (with more specific sub-themes) were identified from the interviews: experiences with using nebulised medicines (cleaning nebuliser, time taken to use nebuliser medicine, flexibility in use of nebuliser); feelings about using nebulised medicines (necessary/important, dislike, part of life); factors impacting non-adherence (time consuming therapy, side effects/effects of medicine, work/social demands, lack of perceived importance); factors and strategies facilitating adherence (perceived medicine importance, habit/routine, support, health benefits, technology/medicine dose form, timetabling).
  
  
  CONCLUSIONS
  Nebulised therapy for cystic fibrosis patients takes a substantial amount of time, with patients trying to alter their routine to incorporate nebulising into their daily lives. However there are still many factors that lead to low adherence, including work/social demands and travelling. Patients balance the necessity for nebulised therapy against the barriers, and engage in intentional non-adherence at times. Future strategies and resources should target and address specific factors identified by patients with CF as being important and impacting their adherence to nebulised medicines.
authors.affiliation: Faculty of Pharmacy, Pharmacy and Bank Building A15, The University of Sydney, Broadway, NSW, 2006, Australia.
authors.forename: Alice
authors.initials: A
authors.lastname: Hogan
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Bonney
authors.forename: Jo-Anne
authors.initials: JA
authors.lastname: Brien
authors.forename: Rita
authors.initials: R
authors.lastname: Karamy
authors.forename: Parisa
authors.initials: P
authors.lastname: Aslani
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000592:standards*; D036301:Qualitative Research; D055815:Young Adult