Chest
Clinical Investigations; Articles; Nebs and FlowsPredictors of Patient Adherence to Long-term Home Nebulizer Therapy for COPD
Section snippets
IPPB Study
Altogether 985 subjects with COPD were enrolled in five centers in the United States and Canada. The IPPB Study protocol is available elsewhere5 and is summarized for this analysis. The study was approved by the institutional committee on human research at each of the clinical centers. All subjects provided informed consent to participate in the study. Patient selection criteria are summarized in Table 1. All study participants were randomly assigned to IPPB or nebulizer therapy. They were
Results
Altogether 50.6% (n=498) of the patients were adherent (used their nebulizers 25 min/d or more), while 49.4% (n=487) were nonadherent. The mean (±SD) elapsed-time meter readings were 26.8±18.0 for all patients, 40.6±13.0 for adherent patients, and 12.5±7.5 for nonadherent patients (p<0.001). Nebulizer use did not change significantly in either of the adherence groups during the course of the study. Adherent patients reported that they used their nebulizers an average of 44.1 ±12.1 min/day,
Predictors of Adherence
We were able to predict which subjects would be adherent to long-term home nebulizer therapy by analyzing the sociodemographic, physiologic, and quality of life characteristics of subjects when they entered the study. Nebulizer-adherent subjects also tended to take oral theophylline as prescribed and keep clinic appointments.
In contrast to most studies cited in the literature,16 age, marital status, education, severity of symptoms, and race were predictors of adherence to nebulizer therapy.
ACKNOWLEDGMENTS
Participants in the Intermittent Positive Pressure Breathing Trial (an asterisk indicates a principal investigator) were the following: Clinical Centers: Baylor College of Medicine, Houston: Paul Stevens, MD;* and Ruth Abeles, RN; Loma Linda (Calif) University: John E. Hodgkin, MD;* and Eileen Zorn, RN, MS; University of Oklahoma Health Sciences Center, Oklahoma City: David C. Levin, MD:* and Brenda Jaye, RN, and Patricia K. Brannin, RN, MSN, RRT; University of California, San Francisco: Philip
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Cited by (92)
Health-Related Quality of Life Is a Mediator of the Relationship Between Medication Adherence and Cardiac Event-Free Survival in Patients with Heart Failure
2021, Journal of Cardiac FailureCitation Excerpt :Our finding verified our hypothesis that when patients took their medications regularly, their HF condition is better controlled and therefore they have better HRQOL, both emotionally and physically. Some investigators have found no relationship17 or a negative relationship16,17 between medication adherence and HRQOL. The different findings might be due to multiple factors, such as differences in measurements/definitions of medication adherence, HRQOL,16,17 study population,17,47 or medication monitored/assessed.53 For example, in a study in patients with chronic obstructive pulmonary disease, Turner and colleagues found no relationship between medication adherence and HRQOL when HRQOL was assessed by the Sickness Impact Profile (which measured the effect of illness on daily functioning) and a negative relationship when HRQOL was assessed by the Recent Life Changes Questionnaire (measured the effect of illness on lifestyle changes).17
Socioeconomic inequalities in adherence to inhaled maintenance medications and clinical prognosis of COPD
2016, Respiratory MedicineCitation Excerpt :Patients with moderate to very severe COPD may benefit from early retirement as it frees up time and energy for disease management that would otherwise be spent working. Our findings of lower adherence among immigrants corroborate with three US based studies showing poorer adherence among Afro Americans compared to Caucasians [2,29,30]. Jung et al. proposed that differences in adherence in relation to ethnicity were an expression of differences in SES and insurance coverage rather than ethnic origin [29].
Investigating the association between medication adherence and health-related quality of life in COPD: Methodological challenges when using a proxy measure of adherence
2016, Respiratory MedicineCitation Excerpt :Our hypothesis was that more severely ill patients have a higher need for medication and as a result they are more likely to be adherent, thus making a correction for disease severity necessary when studying the association between adherence and HRQoL. Turner and colleagues [31] and Ingebrigtsen and colleagues [27] found that FEV1%pred was worse in the adherent group compared to the non-adherent group, while the FEV1%pred did not significantly differ between these groups in two other studies [32,33]. Previous studies also found that adherence in COPD was influenced by other indicators of disease severity; shortness of breath [27,31], exacerbations [27], and comorbidities such as depression [28,34].
Usability Prototype Smart Portable Nebulizer for Self-care with Respiratory Disorders at Home
2022, Open Access Macedonian Journal of Medical Sciences
Supported by contracts NO1-HR-72901, 72902, 72903, 72904, 72905, and 72906 from the Division of Lung Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, US Department of Health and Human Services. Participants are listed in the Acknowledgments.
Currently at the New England Research Institute.