Patient preference and adherence
Longitudinal Patterns and Patient-Reported Barriers to Maintenance Inhaler Adherence in COPD: A Three-Wave Observational Study Using Routine Follow-Up Records
By Zhang C, Shen Q and Zhou M.
Abstract
Purpose
To describe short-term patterns of maintenance inhaler adherence and patient-reported barriers among adults with chronic obstructive pulmonary disease (COPD), and to examine whether barriers documented at earlier follow-ups were associated with subsequent adherence.
Methods
This single-center longitudinal observational study included 278 adults with COPD followed at approximately 1-month intervals for three waves. Adherence was classified from patient- or caregiver-reported inhaler use obtained through routine semi-structured follow-up during the preceding month; unclear or unassessed use was coded missing. Transparent text rules identified five barrier categories and were validated against independent review of 150 randomly sampled records. The primary temporally ordered analysis used Firth logistic regression to compare Wave 3 low adherence between participants with any barrier documented during Waves 1-2 and those with none. Barrier-category count, adjacent-wave models, contemporaneous generalized estimating equations, and inverse probability-of-observation weighting were secondary or sensitivity analyses.
