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The influence of informal caregivers on adherence in COPD patients
Ranak B Trivedi1, Chris L Bryson, Edmunds Udris
1Northwest Health Services Research and Development (HSR&D) Center of Excellence, VA Puget Sound Health Care System, Seattle, WA, USA. ranak.trivedi@va.gov
Background:
Contributions of informal caregivers to adherence among chronic obstructive pulmonary disease (COPD) patients remain understudied.
Purpose:
This study aims to evaluate the association between caregiver presence and adherence to medical recommendations among COPD patients.
Methods:
Three hundred and seventy-four COPD patients were asked whether they had a caregiver. Medication adherence was assessed using pharmacy refill data. Smoking status was based on patient self-report. One-way ANOVAs and chi-square analyses were performed controlling for age and number of illnesses.
Results:
Compared with the "no caregiver" group, antihypertensive medications adherence was higher in the "spousal caregiver" (0.68 vs. 0.81; 95% CI=0.04 and 0.22) and "non-spousal caregiver" (0.68 vs. 0.80; 95% CI=0.03 and 0.22) groups; long-acting beta agonist adherence was higher in the "spousal caregiver" group (0.60 vs.0.80; 95% CI=0.05 and 0.43). Patients in the "spousal caregiver" group had fewer current smokers compared with the "no caregiver" (χ(2)=16.08; p<0.001) and "non-spousal caregiver" (χ(2)=5.07; p<0.05) groups; those in the "non-spousal caregiver" group reported fewer smokers than the "no caregiver" group (χ(2)=4.54; p<0.05).
Conclusions:
Caregivers, especially spouses, may improve adherence in COPD. Future interventions may target patients without caregivers to optimize COPD management.
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