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Int. J. Environ. Res. Public Health 2019, 16(2), 185; https://doi.org/10.3390/ijerph16020185

Inhaler Technique and Adherence to Inhaled Medications among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam

1
Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam
2
Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
3
Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
4
Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
5
Institute for Global Health Innovations, Duy Tan University, Da Nang 55000, Vietnam
6
Department of Lower Limb Surgery, Vietnam-Germany Hospital, Hanoi 100000, Vietnam
7
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
8
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, MD 21205, USA
9
Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore
10
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
*
Author to whom correspondence should be addressed.
Received: 6 December 2018 / Revised: 22 December 2018 / Accepted: 3 January 2019 / Published: 10 January 2019
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Abstract

Sub-optimal chronic obstructive pulmonary disease (COPD) management has been found largely due to patients’ medication non-adherence and incorrect inhaler technique. This study aimed to examine inhaler use technique and medication adherence among Vietnamese COPD patients as well as potential associated factors. A cross-sectional study involving 70 COPD exacerbators was conducted. Inhaler technique and adherence were evaluated by the 10-item and 12-item Test of Adherence to Inhaler (TAI). Data on the history of COPD, home prescription of inhalers and duration of hospitalization were also collected. Generalized linear regression models were used to determine the associated factors with inhaler use and medication adherence. The results showed that the proportion of patients with good inhaler technique was 22.7% for metered-dose inhalers (MDI), 30.4% for dry powder inhalers (DPI) and 31.8% for soft-mist inhalers (SMI). Full exhalation was the most common mistake. The rates of non-compliance patterns were: “ignorant” (77.1%), “sporadic” (58.6%), and “deliberate” (55.7%). Worse dyspnea, greater health condition impairment, and an increased frequency of exacerbations and hospitalizations were found to be associated negatively with correct inhaler use and treatment adherence. Instructions to COPD patients about using inhalers should focus on correct inhaler technique and adherence even when feeling healthy. View Full-Text
Keywords: COPD; inhaler technique; adherence; TAI; Vietnam COPD; inhaler technique; adherence; TAI; Vietnam
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Ngo, C.Q.; Phan, D.M.; Vu, G.V.; Dao, P.N.; Phan, P.T.; Chu, H.T.; Nguyen, L.H.; Vu, G.T.; Ha, G.H.; Tran, T.H.; Tran, B.X.; Latkin, C.A.; Ho, C.S.H.; Ho, R.C.M. Inhaler Technique and Adherence to Inhaled Medications among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam. Int. J. Environ. Res. Public Health 2019, 16, 185.

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