title: Validation of the 'Test of the Adherence to Inhalers' (TAI) for Asthma and COPD Patients.
abstract: BACKGROUND
  To validate the 'Test of Adherence to Inhalers' (TAI), a 12-item questionnaire designed to assess the adherence to inhalers in patients with COPD or asthma.
  
  
  METHODS
  A total of 1009 patients with asthma or COPD participated in a cross-sectional multicenter study. Patients with electronic adherence ≥80% were defined as adherents. Construct validity, internal validity, and criterion validity were evaluated. Self-reported adherence was compared with the Morisky-Green questionnaire.
  
  
  RESULTS
  Factor analysis study demonstrated two factors, factor 1 was coincident with TAI patient domain (items 1 to 10) and factor 2 with TAI health-care professional domain (items 11 and 12). The Cronbach's alpha was 0.860 and the test-retest reliability 0.883. TAI scores correlated with electronic adherence (ρ=0.293, p=0.01). According to the best cut-off for 10 items (score 50, area under the ROC curve 0.7), 569 (62.5%) patients were classified as non-adherents. The non-adherence behavior pattern was: erratic 527 (57.9%), deliberate 375 (41.2%), and unwitting 242 (26.6%) patients. As compared to Morisky-Green test, TAI showed better psychometric properties.
  
  
  CONCLUSIONS
  The TAI is a reliable and homogeneous questionnaire to identify easily non-adherence and to classify from a clinical perspective the barriers related to the use of inhalers in asthma and COPD.
authors.affiliation: 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau) , Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
authors.forename: Vicente
authors.initials: V
authors.lastname: Plaza
authors.affiliation: 2 Facultad de Psicología, Universidad de Oviedo , Oviedo, Asturias, Spain .
authors.forename: Concepción
authors.initials: C
authors.lastname: Fernández-Rodríguez
authors.affiliation: 3 Pulmonology Department, Instituto de Investigación, Hospital Universitario 12 de Octubre , Madrid, Spain .
authors.forename: Carlos
authors.initials: C
authors.lastname: Melero
authors.affiliation: 4 Department of Respiratory Medicine, Hospital Son Espases-IdISPa , Palma de Mallorca. CIBER Enfermedades Respiratorias (CIBERES), Spain .
authors.forename: Borja G
authors.initials: BG
authors.lastname: Cosío
authors.affiliation: 5 Pulmonology Department, Hospital Reina Sofía , Córdoba, Spain .
authors.forename: Luís Manuel
authors.initials: LM
authors.lastname: Entrenas
authors.affiliation: 6 Pulmonology Department, Hospital Universitario Lucus Augusti. Lugo , Spain .
authors.forename: Luis Pérez
authors.initials: LP
authors.lastname: de Llano
authors.affiliation: 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau) , Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
authors.forename: Fernando
authors.initials: F
authors.lastname: Gutiérrez-Pereyra
authors.affiliation: 7 Medical Department, Chiesi Spain, L'Hospitalet de Llobregat , Barcelona, Spain . Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Tarragona
authors.affiliation: 8 Área de investigación aplicada, GOC Networking , Barcelona, Spain .
authors.forename: Rosa
authors.initials: R
authors.lastname: Palomino
authors.affiliation: 9 Pulmonology Department, Hospital Universitario Puerta de Hierro Majadahonda , Madrid, Spain .
authors.forename: Antolín
authors.initials: A
authors.lastname: López-Viña
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010865:Pilot Projects; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D001993:Bronchodilator Agents
keywords: anti-asthmatic agents, administration and dosage; inhalers; medication adherence; medication non-adherence; pulmonary disease, chronic obstructive, drug therapy; questionnaires; validation studies