RT Journal Article
SR Electronic
T1 Adherence to Airway Clearance Therapies by Adult Cystic Fibrosis Patients
JF Respiratory Care
FD American Association for Respiratory Care
SP 279
OP 285
DO 10.4187/respcare.01389
VO 58
IS 2
A1 Flores, Josani Silva
A1 Teixeira, Fernanda Ângela
A1 Rovedder, Paula Maria Eidt
A1 Ziegler, Bruna
A1 Dalcin, Paulo de Tarso Roth
YR 2013
UL http://rc.rcjournal.com/content/58/2/279.abstract
AB BACKGROUND: Airway clearance therapy (ACT) is critical in cystic fibrosis (CF). OBJECTIVES: To determine rates of self-reported adherence to ACT by patients treated in an adult CF program, to identify patient characteristics associated with poor adherence, to typify adherence according to ACT technique, and to indicate reasons for poor adherence. METHODS: Our cross-sectional study included CF subjects age 16 years and older. Enrollees were evaluated via general structured questionnaire, adherence questionnaire, clinical assessment, spirometry, and SpO2 values. Each was stratified by self-reporting protocol as high, moderate, or poor adherence to ACT. Concordance between physiotherapist recommended ACT technique and self-reported subject adherence was subjected to agreement analysis. RESULTS: Of the 63 subjects studied, 38 (60%) qualified as high adherence, 12 (19%) as moderate adherence, and 13 (21%) as poor adherence. Logistic regression identified education level (less than high school) as an independent factor associated with poor adherence (odds ratio 10.2, 95% CI 1.23–84.7, P = .03). Positive expiratory pressure (κ = 0.87) and flutter device (κ = 0.63) usage both corresponded with a high level of agreement, while active cycle of breathing technique (κ = 0.40) and autogenic drainage (κ = 0.39) each showed moderate agreement. Agreement was low for percussion and postural drainage (κ = 0.23). Reasons given most frequently for poor adherence to ACT were “not enough time to do ACT” (28%), “cannot be bothered” (16%), and “do not enjoy ACT technique” (8%). Many (32%) provided no reason. CONCLUSIONS: Study outcomes showed a high rate of ACT adherence in adult CF subjects. Lower level of education was the most important factor in poor adherence to ACT. Self-reported adherence and treatment recommendations were in best agreement with positive expiratory pressure and flutter device techniques.