Catherine Moran1, Frank Doyle1, Imran Sulaiman2,3, Kathleen Bennett4, Garrett Greene1, Gerard J Molloy5, Richard B Reilly6,7,8, Richard W Costello2,3, Lisa Mellon1. 1. a Department of Psychology, Division of Population Sciences , Royal College of Surgeons in Ireland , Dublin , Ireland. 2. b Department of Respiratory Medicine , Royal College of Surgeons in Ireland , Dublin , Ireland. 3. c Clinical Research Centre , Royal College of Surgeons in Ireland , Dublin , Ireland. 4. d Division of Population Sciences , Royal College of Surgeons in Ireland , Dublin , Ireland. 5. e School of Psychology , National University of Ireland Galway , Galway , Ireland. 6. f Trinity Centre for Bioengineering, Trinity College , The University of Dublin , Dublin , Ireland. 7. g School of Engineering, Trinity College , The University of Dublin , Dublin , Ireland. 8. h School of Medicine, Trinity College , The University of Dublin , Dublin , Ireland.
Abstract
OBJECTIVE: To compare the Inhaler Compliance AssessmentTM (INCATM), a novel audio-recording device objectively measuring timing and proficiency of inhaler use, against established adherence measures, and explore its discriminant and predictive validity. DESIGN: Prospective observational study; 184 chronic obstructive pulmonary disease (COPD) patients used an INCATM-enabled salmeterol/fluticasone inhaler for one-month post-hospital discharge. MAIN OUTCOME MEASURES: INCATM (Attempted, Attempted Interval, Actual) adherence correlated with Doses Used Rate, self-reported adherence and prescription refill for concurrent validity. Discriminant validity for reason for admission, cognition and lung function; predictive validity for health status and quality-of-life. RESULTS: Rates of Attempted, Attempted Interval and Actual adherence were 59, 47 and 23%, respectively. Only 7% of participants had Actual adherence >80%. INCATM variables significantly correlated with Doses Used Rate but not with self-report; Attempted and Attempted Interval were weakly associated with prescription refill. Higher cognitive and lung functioning groups had better INCATM adherence. Attempted and Attempted Interval predicted health status, while Doses Used Rate predicted quality-of-life. CONCLUSION: INCATM did not strongly correlate with self-report or prescription refill data. Discriminant and predictive validity demonstrated by INCATM suggests the potential utility of the INCATM as a method to identify intentional and unintentional adherence to inhaled medication and facilitate targeted intervention.
OBJECTIVE: To compare the Inhaler Compliance AssessmentTM (INCATM), a novel audio-recording device objectively measuring timing and proficiency of inhaler use, against established adherence measures, and explore its discriminant and predictive validity. DESIGN: Prospective observational study; 184 chronic obstructive pulmonary disease (COPD) patients used an INCATM-enabled salmeterol/fluticasone inhaler for one-month post-hospital discharge. MAIN OUTCOME MEASURES: INCATM (Attempted, Attempted Interval, Actual) adherence correlated with Doses Used Rate, self-reported adherence and prescription refill for concurrent validity. Discriminant validity for reason for admission, cognition and lung function; predictive validity for health status and quality-of-life. RESULTS: Rates of Attempted, Attempted Interval and Actual adherence were 59, 47 and 23%, respectively. Only 7% of participants had Actual adherence >80%. INCATM variables significantly correlated with Doses Used Rate but not with self-report; Attempted and Attempted Interval were weakly associated with prescription refill. Higher cognitive and lung functioning groups had better INCATM adherence. Attempted and Attempted Interval predicted health status, while Doses Used Rate predicted quality-of-life. CONCLUSION: INCATM did not strongly correlate with self-report or prescription refill data. Discriminant and predictive validity demonstrated by INCATM suggests the potential utility of the INCATM as a method to identify intentional and unintentional adherence to inhaled medication and facilitate targeted intervention.
Authors: Lisa Mellon; Frank Doyle; Anne Hickey; Kenneth D Ward; Declan G de Freitas; P Aiden McCormick; Oisin O'Connell; Peter Conlon Journal: Cochrane Database Syst Rev Date: 2022-09-12
Authors: Terence E Taylor; Yaniv Zigel; Clarice Egan; Fintan Hughes; Richard W Costello; Richard B Reilly Journal: Sci Rep Date: 2018-02-01 Impact factor: 4.379