ArticleBMJ open respiratory research2021
Determinants of poor inhaler technique and poor therapy adherence in obstructive lung diseases: a cross-sectional study in community pharmacies.
Article in BMJ open respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 34 citations in OpenAlex.
- Validation and Reliability Assessment of the Test of Adherence to Inhalers (TAI) in Turkish Patients with Chronic Obstructive Pulmonary Disease (COPD).Thoracic research and practice · 2026Article
- Knowledge, attitude, practice and training of inhalation therapy among respiratory nurses: a cross-sectional study on the current status and influencing factors.Scientific reports · 2026Article
- Exacerbations and Decreased Lung Function Predict Nebulizer Use and Uptake in COPD and Tobacco Exposed Persons With Preserved SpirometryChronic obstructive pulmonary diseases (Miami, Fla.) · 2026Article
- Recent Advances in Inhalation Therapy: An Overview.Pharmaceuticals (Basel, Switzerland) · 2026Article
- An expert opinion on the management of pediatric patients with wheezing and mild asthma: translating 2025 GINA strategy report into clinical practice in Italy.Italian journal of pediatrics · 2026Review
- Optimizing COPD Care in Belgium: A Multidisciplinary Expert Consensus on Cardiopulmonary Risk Management.International journal of chronic obstructive pulmonary disease · 2026Article
- Treatment Adherence and Treatment Effectiveness in Stable Chronic Obstructive Pulmonary Disease Among Outpatients at An Giang Province, Vietnam.Pulmonary medicine · 2026Article
- Article
- Pressurized Metered-Dose Inhaler Versus Dry Powder Inhaler Adherence Among Individuals with Asthma and COPD.Advances in respiratory medicine · 2025Article
- Impact of the COVID-19 Pandemic on Lung Function and Treatment Decisions in Children with Asthma: A Retrospective Study.Journal of clinical medicine · 2025Article
- Factors associated with low adherence to inhaled therapy in patients with chronic respiratory diseases: a cross-sectional study.BMC pulmonary medicine · 2025Article
- Adherence to Inhalation Therapy Among COPD Patients: A Cross-Sectional Study in a Tertiary Hospital in Quito, Ecuador.International journal of chronic obstructive pulmonary disease · 2025Article
- Inhaler identification: evaluating a potential screening method for adherence in chronic respiratory disease management.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025Observational
- Unlocking Better Asthma Control: A Narrative Review of Adherence to Asthma Therapy and Innovative Monitoring Solutions.Journal of clinical medicine · 2024Review
- Article
- Neglecting the neglected: Tobacco cessation support is essential for the management of asthma and COPD.Tobacco induced diseases · 2024Article
- Clinical pharmacy services are reimbursed in Germany: challenges of real world implementation remain.International journal of clinical pharmacy · 2023Article
- Nurses in China lack knowledge of inhaler devices: A cross-sectional study.Frontiers in pharmacology · 2023Article
- Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission.Lancet (London, England) · 2022Review
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCorrect inhaler use can be challenging in real life, with incorrect use resulting in poor symptom control. The aim of this study was to examine factors associated with poor inhaler technique and poor therapy adherence among patients with obstructive lung disease in community pharmacies.
methodsA cross-sectional study was conducted in patients with obstructive lung diseases in nine Belgian community pharmacies. Logistic regression analyses identified factors associated with poor inhaler technique and poor therapy adherence (assessed by the Test of Adherence to Inhalers and the modified Medication Possession Ratio).
resultsSeventy obstructively impaired community patients (median age 64 y, 56% females) were included and the technique of 122 inhalers was assessed. Inhaler technique scored generally poor, with half of patients making critical errors in using at least one of their inhalers. In multivariable analysis, the use of multiple devices (adjusted OR, aOR 11.68; 95% CI 3.29 to 41.51) and a diagnosis of asthma-Chronic Obstructive Pulmonary Disease overlap (ACO; aOR 7.06; 95% CI 1.15 to 43.35), were associated with making critical errors in inhaler technique independent of quality of life. Non-adherence occurred in more than one-third of patients, and occurred in up to one half of the patients when also taking overuse into account. In multivariable analysis for therapy adherence, current smoking was associated with poor therapy adherence (aOR 0.15; 95% CI 0.02 to 0.96) independently of age and poor treatment knowledge. Therapy adherence was poor in patients with asthma compared with those with ACO. Current smokers and highly educated patients seemed to be at increased risk for inhaler overuse.
conclusionsGiven the important role of a correct inhaler technique and therapy adherence in disease control, these findings emphasise the need for patient education and aiming uniformity in the inhaler device. TRIAL REGISTRATION NUMBER: B670201835229.
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