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Published on: November 8, 2013
Inhaled Medication Adherence Trajectory and Its Associated Factors in Patients with Chronic Obstructive Pulmonary
Haibo Xu1,2, Weiwei Liang2, Yiwen Liang2
1Nursing Department, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, 528200, People's Republic of China.
This study identified four inhaled medication adherence trajectories in COPD patients, revealing that one month post-discharge is a critical period for adherence. Factors like health literacy and anxiety influence these trajectories, necessitating targeted interventions for better COPD management.
Area of Science:
- Pulmonary Medicine
- Health Services Research
- Behavioral Science
Background:
- Chronic Obstructive Pulmonary Disease (COPD) management relies heavily on consistent inhaled medication adherence.
- Understanding the dynamic patterns and influencing factors of adherence is crucial for effective patient care.
- Heterogeneity in adherence trajectories necessitates personalized intervention strategies.
Purpose of the Study:
- To identify distinct trajectories of inhaled medication adherence in COPD patients post-discharge.
- To examine factors associated with these adherence trajectories.
- To explore longitudinal correlations between adherence and other patient-reported outcomes for precise COPD management.
Main Methods:
- Convenience sampling recruited 207 COPD patients from a university hospital.
- Inhaled medication adherence, health literacy, beliefs about medicines, anxiety, and social support were assessed at multiple time points post-discharge.
- Group-Based Trajectory Models and multinomial logistic regression analyzed adherence patterns and associated factors.
Main Results:
- Four distinct inhaled medication adherence trajectories were identified: high adherence-persisting (50.4%), medium-low adherence-persisting (18.4%), low adherence rising-persisting (15.0%), and low adherence rising-declining (16.3%).
- Adherence patterns showed a decrease from hospitalization to one month post-discharge, followed by an increase.
- Factors associated with adherence trajectories included duration of inhaler use, health literacy, beliefs about medicines, anxiety, and perceived social support.
Conclusions:
- Nearly one-third of COPD patients exhibited poor adherence post-discharge, with one month being a critical turning point.
- Duration of inhaler use ≤2 years, low health literacy, negative medicine beliefs, high anxiety, and low social support were linked to poorer adherence trajectories.
- Targeted interventions based on identified adherence trajectories are essential for precision management in COPD patients.
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