[Comparison of adherence as assessed by the Test of Adherence to Inhalers and Pharmacy Refill Records, in Asthma Patients. REFARMA study].

Autores de IDIVAL

• 

  Miguel Santibáñez Margüello

  Autor

• Juan Carlos Lopez Caro

  Autor

• Mariano Rodriguez Porres

  Autor

• Sandra Arenal Barquin

  Autor

• Helena Bermejo Ruiz

  Autor

• José Ramón Fernández Fonfria

  Autor

• Juan Luis García Rivero

  Autor

Autores ajenos al IDIVAL

• Rodríguez I
• Astruga MC
• Alvarez-Cabo JM
• Rivacoba L
• en representación del grupo de investigadores del estudio ACINAR-REFARMA

Unidades

• INVESTIGACIÓN EN ENFERMERÍA

  

  Investigador Responsable

  Carmen María Sarabia Cobo

Abstract

Introduction: Clinical guidelines recommend the combined use of "self-completed questionnaires such as the Test of Adherence to Inhalers (TAI)" and the pharmacy refill rate (PRR) to determine adherence, but evidence based on comparative studies to support these recommendations is limited. Our objective was to determine adherence to inhalers in asthmatic patients, using the TAI and the PRR, as well as the correlation and concordance between both methods. Methods: Multicentre cross-sectional study including the first 196 consecutive adult asthmatic patients, of whom 183 were on maintenance treatment with Inhaled Corticosteroids (ICS). Nonadherence was defined as TAI <50 or PRR <80% in the previous 12 months. Results: A statistically significant positive correlation was observed between TAI and PRR scores (Spearman's rho coefficient=0.185; p=0.012). Prevalence of nonadherence based on TAI was 73.22%; 95%CI (66.54-79.91) and 57.92%; 95%CI (50.50-65.35) based on PRR was. In terms of agreement, a Cohen's kappa index=0.174 and an overall % agreement of 61.7% were obtained. Twenty-two of the 49 patients who scored 50 on TAI (44.9%) refilled <80% of inhalers. In contrast, 48 of the 134 patients who scored =49 on TAI (35.8%) refilled =80% at the pharmacy. Conclusions: Adherence remains suboptimal with prevalences of nonadherent patients>50%. The concordance results supports, in line with guideline recommendations, that the use of both approaches (TAI and PRR) increases the ability to identify poor adherence compared to TAI or PRR alone.

© 2023 Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Published by Elsevier España, S.L.U.

Keywords

• Asma; Adhesión terapéutica; Atención Primaria; Test de Adherencia a Inhaladores; Retirada en farmacia de la medicación; Control del asma; Asthma; Therapeutic adherence; Primary care; Test of Adherence to Inhalers; Pharmacy medication refill; Asthma control