Chest
Original ResearchRespiratory CareAccurate Assessment of Adherence: Self-Report and Clinician Report vs Electronic Monitoring of Nebulizers
Section snippets
Materials and Methods
A cross-sectional comparison of three approaches to measuring adherence (self-report, clinician report, and electronic monitoring through the I-Neb) was undertaken at the Leeds regional CF unit in England. Ethical approval for this study was obtained from the relevant National Health Service local research ethics committee.
Results
Eighty-one patients brought their I-Neb systems to the clinic within the study period, and 80 gave informed consent to take part in the study. Downloaded data could not be obtained in one case because the I-Neb was an older model without the capability to download data and in one case because of malfunction following ingress of water. Data for 78 participants, therefore, were analyzed (Fig 1). Complete data were collected for 63 participants; 15 participants had missing data for the ward nurse
Discussion
Previous studies have shown important differences in the level of patient adherence to treatments when adherence was assessed by reported methods or by electronic monitoring. Nonetheless, report-based estimates of adherence continue to inform important treatment decisions, such as whether to intensify treatment or whether a patient is suitable for further interventions, including transplantation. The present study was designed to directly assess the commonly used adherence measures of
Acknowledgments
Author contributions: Ms Daniels had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Ms Daniels: contributed to the concept for this research; wrote the proposal and submitted it to the ethics committee; made amendments for ethics committee acceptance; carried out data collection; analyzed data with guidance, correction, and assistance from Dr Sutton; and wrote and made amendments to this manuscript based
References (29)
- et al.
High treatment burden in adults with cystic fibrosis: challenges to disease self-management
J Cyst Fibros
(2009) - et al.
A multi-method assessment of treatment adherence for children with cystic fibrosis
J Cyst Fibros
(2006) - et al.
True device compliance: the need to consider both competence and contrivance
Respir Med
(2005) - et al.
An adherence study using data from an AAD device in cystic fibrosis comparing early and late diagnosis [Abstract]
J Cyst Fibros
(2010) - et al.
Open adherence monitoring using routine data download from an adaptive aerosol delivery nebuliser in children with cystic fibrosis
J Cyst Fibros
(2009) - et al.
Adherence to nebulised antibiotics in cystic fibrosis
Patient Educ Couns
(2009) - et al.
Nebulised dornase alpha: adherence in adults with cystic fibrosis
J Cyst Fibros
(2002) - et al.
The diagnosis of cystic fibrosis: a consensus statement
J Pediatr
(1998) - et al.
Inhaled bronchodilators for cystic fibrosis
Cochrane Database Syst Rev
(2005) - et al.
Understanding non-compliance with treatment in adults with cystic fibrosis
J R Soc Med
(2000)
Evidence-based assessment of adherence to medical treatments in pediatric psychology
J Pediatr Psychol
Psychological interventions for people with cystic fibrosis and their families
Cochrane Database Syst Rev
Typologies of nonadherence in cystic fibrosis
J Dev Behav Pediatr
Compliance with treatment in adult patients with cystic fibrosis
Thorax
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Parts of this article have been presented in abstract form (Hughes TE, Pollard K, Black A, Conway SP, Peckham DG. Reported and objective adherence to nebulised therapy in adults with cystic fibrosis [Abstract S64]. J Cyst Fibros. 2008;7[suppl 2]:256 and Hughes TE, Pollard K, Goodacre L, Sutton C, Conway SP, Peckham D. Variation in bias of self-reported adherence to nebulizers in adults with cystic fibrosis [Abstract S92]. J Cyst Fibros. 2009;8[suppl 2]:370).
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).