Validation and Reliability Assessment of the Test of Adherence to Inhalers (TAI) in Turkish Patients with Chronic...

Accurate assessment of inhaler adherence is essential for optimizing treatment outcomes in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the validity and reliability of the Turkish version of the Test of Adherence to Inhalers (TAI) in a multicentre COPD cohort.

A total of 277 patients were included. Sociodemographic characteristics and adherence status [assessed by the Turkish version of the Medication Adherence Report Scale-5 (MARS-5); İlaç Uyumunu Bildirim Ölçeği (İUBÖ)] were recorded. Construct validity was evaluated using confirmatory factor analysis (CFA), criterion validity was evaluated by agreement with İUBÖ using kappa statistics, and known-groups validity was evaluated by comparing the number of inhaler devices used. Reliability was assessed using Cronbach's alpha coefficients and item-total correlations.

The mean age was 66.3±8.3 years, 81.9% of participants were male. Most patients (73.6%) used at least two inhaler devices, and 28.9% were classified as non-adherent according to İUBÖ. Based on TAI scores, 43.3% of patients had good adherence, 23.8% had intermediate adherence, and 32.9% had poor adherence. CFA supported the two-factor structure of the TAI (Tucker-Lewis Index: 0.965; Comparative Fit Index: 0.972; Root Mean Square Error of Approximation: 0.114). Criterion validity was demonstrated by good agreement between TAI and İUBÖ (kappa: 0.637, P < 0.001). Patients using more than one inhaler device were more likely to be non-adherent according to the TAI-10 (P = 0.02). Internal consistency was high for both the 10- and 12-item versions (Cronbach's alpha >0.90), with item-total correlations indicating adequate reliability.

The Turkish version of the TAI is a valid and reliable tool for assessing inhaler adherence in patients with COPD and is suitable for both clinical practice and research settings in Türkiye.