Analysis of Current Status and Influencing Factors of Inhaler Treatment Adherence Among COPD Patients

To investigate the current status of inhaler treatment adherence and analyze its influencing factors among patients with chronic obstructive pulmonary disease (COPD) based on the clinical treatment data of a tertiary grade A hospital.

A retrospective study design was adopted. COPD patients who received inhaler treatment at The First Affiliated Hospital of Shihezi University from July to December 2023 were enrolled. Their medical visit records, prescription data within 18 months after enrollment, and medical insurance reimbursement records were collected. Medication adherence was evaluated using proportion of days' supply covered (PDC) calculated from prescription and reimbursement records, not by direct measurement of actual inhaler, and patients were divided into three groups. The relationships between adherence and patients' basic characteristics, disease-related factors, and inhaler usage were analyzed.

A total of 706 patients were included in the study. Overall, patient adherence was poor as assessed by PDC, mean PDC of 43.67% ± 32.44%. Among them, 18.42% of patients had high adherence and 60.48% had low adherence. Male patients and those with a smoking history had higher adherence. The inhaler treatment adherence of COPD patients increased with the aggravation of the disease (Gamma = 0.267, p = 0.024), the prolongation of disease duration (r = 0.155, p < 0.01), and the increase in the number of acute exacerbations (p < 0.01). Patients using fluticasone furoate/vilanterol/umeclidinium bromide inhalation powder had higher overall adherence than those using budesonide/formoterol fumarate inhalation powder.

Among patients with COPD at our hospital, adherence to inhaled therapy as measured by PDC is generally low. Lower PDC was observed in newly diagnosed patients and those without a history of acute exacerbations. In clinical practice, greater emphasis should be placed on medication education and long-term management for these patients.