Medication adherence and its influencing factors in patients with chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

MA Rui ¹ , DONG Xinyue ² ,  TAO Tiantian ¹ ,  DU Wenmin ¹ , SHAO Rong ³

1. School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, P. R. China;
2. School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P. R. China;
3. Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu 211198, P. R. China;

Corresponding author：

TAO Tiantian, Email: tt-tao@njmu.edu.cn; DU Wenmin, Email: wenmindu@hotmail.com

Keywords：

Chronic obstructive pulmonary disease; medication adherence; influencing factors; MMAS-8

DOI：

10.7507/1671-6205.202307037

Video：

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Objective To retrospectively collect data on patients with stable chronic obstructive pulmonary disease (COPD), and explore the current status of medication adherence and its main influencing factors in China.Methods According to the principle of convenience, 293 patients with COPD were enrolled in 16 tertiary hospitals located in Nanjing, Hefei, Wuhu, Xuzhou, and Chuzhou. The status quo and influencing factors of medication adherence in COPD patients were identified and analyzed by using the 8-item Morisky Drug Compliance Scale, Beliefs about Medicines Questionnaire, Hospital Anxiety and Depression Scale, General Self-Efficacy Scale, and modified British Medical Research Council. The analysis was based on the framework provided by the WHO’s "five-dimensional determinants" and the mathematical relationship was demonstrated through sequential logistic regression analysis. Results The medication adherence of the target population is 11.95%. A higher socio-economic status [odds ratio (OR) 0.30, 95% confidential interval (CI) 0.10 - 0.91], patients’ general beliefs about the medication utility (OR 0.29, 95%CI 0.17 - 0.50) and overuse (OR 0.30, 95%CI 0.16 - 0.55) were associated with a lower chance of being adherent in patients with COPD. While disease severity (OR 2.01, 95%CI 1.11 - 3.64) and types of drug use (OR 1.91, 95%CI 1.07 - 3.41) presented opposite results. Conclusions Medication adherence in domestic patients with COPD is not satisfactory at the present stage. Effective ways to improve patients’ medication adherence and quality of life could be proposed from the national, living environment and individual three dimensions.

Citation： MA Rui, DONG Xinyue, TAO Tiantian, DU Wenmin, SHAO Rong. Medication adherence and its influencing factors in patients with chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(8): 533-538. doi: 10.7507/1671-6205.202307037 Copy

1.	张卫国. 家庭医生签约式服务对慢性病患者治疗依从性的影响. 中国农村卫生, 2019, 11(15): 65, 67.
2.	Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3.	Adeloye D, Chua S, Lee C, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health, 2015, 5(2): 020415.
4.	Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom, 2018, 3: e4.
5.	GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015, 385(9963): 117-171.
6.	World Health Organization. Projections of mortality and causes of death, 2015 and 2030[EB/OL]. (2018-10-14) [2019-08-31]. http://www.who.int/healthinfo/global_burden_disease/projections/en/.
7.	American Thoracic Society Foundation. The Global Burden of Lung Disease[EB/OL]. (2014) [2019]. http://foundation.thoracic.org/news/global-burden.php.
8.	Guarascio AJ, Ray SM, Finch CK, et al. The clinical and economic burden of chronic obstructive pulmonary disease in the USA. Clinicoecon Outcomes Res, 2013, 5: 235-245.
9.	Zhu BF, Wang YF, Ming J, et al. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis, 2018, 13: 1353-1364.
10.	舒宏, 崔一民, 侯曙光. 肺部吸入给药制剂及临床应用. 临床药物治疗杂志, 2014, 2(2): 18-24.
11.	Haupt D, Krigsman K, Nilsson JL. Medication persistence among patients with asthma/COPD drugs. Pharm World Sci, 2008, 30(5): 509-514.
12.	Serra-Batlles J, Plaza V, Badiola C, et al. Patient perception and acceptability of multidose dry powder inhalers: a randomized crossover comparison of Diskus/Accuhaler with Turbuhaler. J Aerosol Medi, 2002, 15(1): 59-64.
13.	Rolnick SJ, Pawloski PA, Hedblom BD, et al. Patient characteristics associated with medication adherence. Clin Med Res, 2013, 11(2): 54-65.
14.	李材忠. 慢性阻塞性肺疾病稳定期患者院外使用吸入制剂的依从性分析. 临床肺科杂志, 2018, 23(8): 1455-1459.
15.	林佳媛, 何乐, 徐斌, 等. 慢性阻塞性肺疾病患者吸入制剂依从性调查. 临床肺科杂志, 2017, 22(4): 658-661.
16.	吉冬元, 邹勇, 孟庆华, 等. 全球慢性阻塞性肺疾病防治创议干预计划实施的依从性调查及影响因素分析. 中国临床康复, 2005, 9(32): 42-44.
17.	陈威飞, 龚娜. 老年慢阻肺患者治疗依从性调查及影响因素研究. 中国医院统计, 2016, 23(6): 436-438.
18.	李洪超, 官海静, 刘国恩. 我国社区2型糖尿病患者用药依从性影响因素研究. 中国药房, 2019, 30(24): 3448-3451.
19.	王芳, 宋俊伟, 王新生. 社区高血压患者用药依从性及影响因素分析. 中国公共卫生管理, 2017, 33(2): 214-216.
20.	Krauskopf K, Federman AD, Kale MS, et al. Chronic obstructive pulmonary disease illness and medication beliefs are associated with medication adherence. COPD, 2015, 12(2): 151-164.
21.	Rogliani P, Ora J, Puxeddu E, et al. Adherence to COPD treatment: myth and reality. Respir Med, 2017, 129: 117-123.
22.	Bosnic-Anticevich S, Chrystyn H, Costello RW, et al. The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes. Int J Chron Obstruct Pulmon Dis, 2016, 12: 59-71.

1. 张卫国. 家庭医生签约式服务对慢性病患者治疗依从性的影响. 中国农村卫生, 2019, 11(15): 65, 67.
2. Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3. Adeloye D, Chua S, Lee C, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health, 2015, 5(2): 020415.
4. Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom, 2018, 3: e4.
5. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015, 385(9963): 117-171.
6. World Health Organization. Projections of mortality and causes of death, 2015 and 2030[EB/OL]. (2018-10-14) [2019-08-31]. http://www.who.int/healthinfo/global_burden_disease/projections/en/.
7. American Thoracic Society Foundation. The Global Burden of Lung Disease[EB/OL]. (2014) [2019]. http://foundation.thoracic.org/news/global-burden.php.
8. Guarascio AJ, Ray SM, Finch CK, et al. The clinical and economic burden of chronic obstructive pulmonary disease in the USA. Clinicoecon Outcomes Res, 2013, 5: 235-245.
9. Zhu BF, Wang YF, Ming J, et al. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis, 2018, 13: 1353-1364.
10. 舒宏, 崔一民, 侯曙光. 肺部吸入给药制剂及临床应用. 临床药物治疗杂志, 2014, 2(2): 18-24.
11. Haupt D, Krigsman K, Nilsson JL. Medication persistence among patients with asthma/COPD drugs. Pharm World Sci, 2008, 30(5): 509-514.
12. Serra-Batlles J, Plaza V, Badiola C, et al. Patient perception and acceptability of multidose dry powder inhalers: a randomized crossover comparison of Diskus/Accuhaler with Turbuhaler. J Aerosol Medi, 2002, 15(1): 59-64.
13. Rolnick SJ, Pawloski PA, Hedblom BD, et al. Patient characteristics associated with medication adherence. Clin Med Res, 2013, 11(2): 54-65.
14. 李材忠. 慢性阻塞性肺疾病稳定期患者院外使用吸入制剂的依从性分析. 临床肺科杂志, 2018, 23(8): 1455-1459.
15. 林佳媛, 何乐, 徐斌, 等. 慢性阻塞性肺疾病患者吸入制剂依从性调查. 临床肺科杂志, 2017, 22(4): 658-661.
16. 吉冬元, 邹勇, 孟庆华, 等. 全球慢性阻塞性肺疾病防治创议干预计划实施的依从性调查及影响因素分析. 中国临床康复, 2005, 9(32): 42-44.
17. 陈威飞, 龚娜. 老年慢阻肺患者治疗依从性调查及影响因素研究. 中国医院统计, 2016, 23(6): 436-438.
18. 李洪超, 官海静, 刘国恩. 我国社区2型糖尿病患者用药依从性影响因素研究. 中国药房, 2019, 30(24): 3448-3451.
19. 王芳, 宋俊伟, 王新生. 社区高血压患者用药依从性及影响因素分析. 中国公共卫生管理, 2017, 33(2): 214-216.
20. Krauskopf K, Federman AD, Kale MS, et al. Chronic obstructive pulmonary disease illness and medication beliefs are associated with medication adherence. COPD, 2015, 12(2): 151-164.
21. Rogliani P, Ora J, Puxeddu E, et al. Adherence to COPD treatment: myth and reality. Respir Med, 2017, 129: 117-123.
22. Bosnic-Anticevich S, Chrystyn H, Costello RW, et al. The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes. Int J Chron Obstruct Pulmon Dis, 2016, 12: 59-71.

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