Home nebulized therapy for patients with COPD: patient compliance with treatment and its relation to quality of life

To assess compliance with home nebulized therapy in patients with COPD.

Patients' home nebulizers were replaced with nebulizers that recorded the date and time of each treatment over a period of 4 weeks. Poor compliance was defined as taking <70% of the prescribed dose (or <60% for those prescribed treatments five or more times daily).

Patients were seen at the hospital COPD outpatient clinic. The compliance data obtained were recorded while they were at home.

Ninety-three patients aged 44 to 76 years (mean, 64.9 years) were recruited from the hospital nebulizer database.

Patients completed a self-reported quality of life scale, the St. George's Respiratory Questionnaire (SGRQ), both before (SGRQ1) and after (SGRQ2) the 4-week study period to look at whether quality of life was either predictive of or subsequent to level of compliance.

Data were obtained from 82 patients. Mean compliance was 57% (range, 0 to 124%). Thirty-six (44%) patients were compliant and 46 (56%) were poorly compliant. There was no difference between the two groups in age or sex distribution. Compliance was negatively correlated with the total score on the SGRQ2 (p=0.03).

The study shows that levels of compliance with nebulized therapy are low in a large proportion of patients with COPD and that patients with low levels of compliance report greater impairment in their quality of life.