Evidence map›Paper›PMID 32977779›Full record

ArticleBMC pulmonary medicine2020

Adherence to inhalers and comorbidities in COPD patients. A cross-sectional primary care study from Greece.

Despo Ierodiakonou, Dimitra Sifaki-Pistolla, Maria Kampouraki, Ioannis Poulorinakis, Polyvios Papadokostakis, Ioannis Gialamas, Polyxeni Athanasiou, Vasiliki Bempi, Irene Lampraki, Ioanna Tsiligianni and 1 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pulmonary medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06599177 (Patients with COPD), which is not on this map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
2.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06599177 naactive not recruitingnot on this mapstarted 2024, after this paper: background citation

Patients with COPD: Assessment of Psychosocial Status and the Impact of Psychosocial Interventions

TypeinterventionalSponsorUniversity of CreteRan2024 to 2026Enrolled160ConditionsChronic Obstructive Pulmonary Disease (COPD)ArmsInformational leaflet
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 42 citations in OpenAlex.

  1. Article
  2. Article
  3. Quality of Care and Outcomes of Inpatients with COPD: A Multi-Center Study in China.International journal of chronic obstructive pulmonary disease · 2025
    Observational
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  14. Review
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  16. Adherence to Inhaled Therapy in Patients with COPD Associated to Pneumoconiosis.International journal of chronic obstructive pulmonary disease
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Despo IerodiakonouHealth Planning Unit. Department of Social Medicine, Faculty of Medicine, University of Crete, Voutes Campus, Heraklion, GR-71003, Crete, Greece.
Dimitra Sifaki-PistollaHealth Planning Unit. Department of Social Medicine, Faculty of Medicine, University of Crete, Voutes Campus, Heraklion, GR-71003, Crete, Greece.
Maria KampourakiPrimary Care Practice, Health Center of Moires, Heraklion, Crete, Greece.
Ioannis PoulorinakisPrimary Care Practice, Health Center of Agia Varvara, Heraklion, Crete, Greece.
Polyvios PapadokostakisPrimary Care Practice, Garipa, Heraklion, Crete, Greece.
Ioannis GialamasPrimary Care Practice, Health Center of Sitia, Sitia General Hospital, Lasithi, Crete, Greece.
Polyxeni AthanasiouDepartment of Public Health, Heraklion University Hospital, Heraklion, Crete, Greece.
Vasiliki BempiDepartment of Public Health, Heraklion University Hospital, Heraklion, Crete, Greece.
Irene LamprakiDepartment of Public Health, Heraklion University Hospital, Heraklion, Crete, Greece.
Ioanna TsiligianniHealth Planning Unit. Department of Social Medicine, Faculty of Medicine, University of Crete, Voutes Campus, Heraklion, GR-71003, Crete, Greece. i.tsiligianni@uoc.gr.
Greek UNLOCK group
University Hospital of Heraklion · GRUniversity of Crete · GRThe Sitia Development Organisation · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComorbidities 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.

methodsTwo 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.

results74.1% 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.

conclusionsPoor 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.

Indexed as

Drug MonitoringAdministration, InhalationAgedAged, 80 and overBronchodilator AgentsComorbidityCross-Sectional StudiesDiabetes MellitusFemaleGreeceHealth StatusHumansHypertensionLinear ModelsLogistic ModelsLungBronchodilator AgentsAdherenceComorbiditiesCOPDExacerbationsGOLD2019Health status

Identifiers

PMID32977779
PMCPMC7519509
OpenAlexW3088399108

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.