Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece
Abstract Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treatment goals, health status and disease control in chronic obstructive pulmonary disease (COPD). Aim of the study was to assess levels of adherence to inhalers, comorbidities and associations with...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12890-020-01296-3 |
| _version_ | 1819226904284102656 |
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| author | Despo Ierodiakonou Dimitra Sifaki-Pistolla Maria Kampouraki Ioannis Poulorinakis Polyvios Papadokostakis Ioannis Gialamas Polyxeni Athanasiou Vasiliki Bempi Irene Lampraki Ioanna Tsiligianni On behalf of the Greek UNLOCK group |
| author_facet | Despo Ierodiakonou Dimitra Sifaki-Pistolla Maria Kampouraki Ioannis Poulorinakis Polyvios Papadokostakis Ioannis Gialamas Polyxeni Athanasiou Vasiliki Bempi Irene Lampraki Ioanna Tsiligianni On behalf of the Greek UNLOCK group |
| author_sort | Despo Ierodiakonou |
| collection | DOAJ |
| description | Abstract Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treatment goals, health status and disease control in chronic obstructive pulmonary disease (COPD). Aim of the study was to assess levels of adherence to inhalers, comorbidities and associations with COPD outcomes in patients residing in rural and semi-urban areas of Greece. Methods Two hundred fifty-seven COPD patients were enrolled from primary health care in 2015–2016. Physicians used structured interviews and questionnaires to assess quality of life and disease status. Patients were classified into groups according to GOLD 2019 guidelines (based on CAT and mMRC). Adherence to inhalers was measured with the Test of Adherence to Inhalers (TAI). Multivariate linear and logistics regression models were used to assess associations between comorbidities and adherence to inhalers with COPD outcomes, including CAT and mMRC scores, exacerbations and GOLD A-D status. Results 74.1% of COPD patients reported poor adherence, while most of them were characterized as deliberate non-compliers (69.5%). 77.1% had ≥2 comorbidities, with overweight/obese (82.2%), hypertension (72.9%) and diabetes mellitus (58%) being the most prevalent. In multivariate analysis, COPD outcomes having significant associations with poor adherence included worse health status [OR (95% CI) 4.86 (1.61–14.69) and 2.93 (1.51–5.71) based on CAT and mMRC, respectively], having ≥2 exacerbations in the past year [4.68 (1.51–4.44)], and disease status e.g., be in groups C or D [3.13 (1.49–8.53) and 3.35 (1.24–9.09) based on CAT and mMRC, respectively). Subjects with gastroesophageal reflux showed better inhaler adherence [OR (95% CI) 0.17 (0.6–0.45)], but none of the comorbid conditions was associated with COPD outcomes after adjustments. Conclusions Poor adherence to inhalers and comorbidities are both prevalent in COPD patients of primary care residing in rural/semi-urban areas of Greece, with adherence influencing COPD outcomes. Raising awareness of patients and physicians on the importance of comorbidities control and inhaler adherence may lead to interventions and improve outcomes. |
| first_indexed | 2024-12-23T10:32:54Z |
| format | Article |
| id | doaj.art-0a403cab6d4548d28845c3981f9541af |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-23T10:32:54Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-0a403cab6d4548d28845c3981f9541af2022-12-21T17:50:22ZengBMCBMC Pulmonary Medicine1471-24662020-09-0120111010.1186/s12890-020-01296-3Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from GreeceDespo Ierodiakonou0Dimitra Sifaki-Pistolla1Maria Kampouraki2Ioannis Poulorinakis3Polyvios Papadokostakis4Ioannis Gialamas5Polyxeni Athanasiou6Vasiliki Bempi7Irene Lampraki8Ioanna Tsiligianni9On behalf of the Greek UNLOCK groupHealth Planning Unit. Department of Social Medicine, Faculty of Medicine, University of CreteHealth Planning Unit. Department of Social Medicine, Faculty of Medicine, University of CretePrimary Care Practice, Health Center of MoiresPrimary Care Practice, Health Center of Agia VarvaraPrimary Care PracticePrimary Care Practice, Health Center of Sitia, Sitia General HospitalDepartment of Public Health, Heraklion University HospitalDepartment of Public Health, Heraklion University HospitalDepartment of Public Health, Heraklion University HospitalHealth Planning Unit. Department of Social Medicine, Faculty of Medicine, University of CreteAbstract Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treatment goals, health status and disease control in chronic obstructive pulmonary disease (COPD). Aim of the study was to assess levels of adherence to inhalers, comorbidities and associations with COPD outcomes in patients residing in rural and semi-urban areas of Greece. Methods Two hundred fifty-seven COPD patients were enrolled from primary health care in 2015–2016. Physicians used structured interviews and questionnaires to assess quality of life and disease status. Patients were classified into groups according to GOLD 2019 guidelines (based on CAT and mMRC). Adherence to inhalers was measured with the Test of Adherence to Inhalers (TAI). Multivariate linear and logistics regression models were used to assess associations between comorbidities and adherence to inhalers with COPD outcomes, including CAT and mMRC scores, exacerbations and GOLD A-D status. Results 74.1% of COPD patients reported poor adherence, while most of them were characterized as deliberate non-compliers (69.5%). 77.1% had ≥2 comorbidities, with overweight/obese (82.2%), hypertension (72.9%) and diabetes mellitus (58%) being the most prevalent. In multivariate analysis, COPD outcomes having significant associations with poor adherence included worse health status [OR (95% CI) 4.86 (1.61–14.69) and 2.93 (1.51–5.71) based on CAT and mMRC, respectively], having ≥2 exacerbations in the past year [4.68 (1.51–4.44)], and disease status e.g., be in groups C or D [3.13 (1.49–8.53) and 3.35 (1.24–9.09) based on CAT and mMRC, respectively). Subjects with gastroesophageal reflux showed better inhaler adherence [OR (95% CI) 0.17 (0.6–0.45)], but none of the comorbid conditions was associated with COPD outcomes after adjustments. Conclusions Poor adherence to inhalers and comorbidities are both prevalent in COPD patients of primary care residing in rural/semi-urban areas of Greece, with adherence influencing COPD outcomes. Raising awareness of patients and physicians on the importance of comorbidities control and inhaler adherence may lead to interventions and improve outcomes.http://link.springer.com/article/10.1186/s12890-020-01296-3COPDAdherenceComorbiditiesExacerbationsHealth statusGOLD2019 |
| spellingShingle | Despo Ierodiakonou Dimitra Sifaki-Pistolla Maria Kampouraki Ioannis Poulorinakis Polyvios Papadokostakis Ioannis Gialamas Polyxeni Athanasiou Vasiliki Bempi Irene Lampraki Ioanna Tsiligianni On behalf of the Greek UNLOCK group Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece BMC Pulmonary Medicine COPD Adherence Comorbidities Exacerbations Health status GOLD2019 |
| title | Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece |
| title_full | Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece |
| title_fullStr | Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece |
| title_full_unstemmed | Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece |
| title_short | Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece |
| title_sort | adherence to inhalers and comorbidities in copd patients a cross sectional primary care study from greece |
| topic | COPD Adherence Comorbidities Exacerbations Health status GOLD2019 |
| url | http://link.springer.com/article/10.1186/s12890-020-01296-3 |
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