A Latent Class Analysis of Inhaled Medication Adherence and Influencing Factors in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background:

Adherence to inhaled medication adherence is critical for reducing the risk of acute exacerbations, controlling disease progression, improving quality of life and lowering healthcare costs in patients with chronic obstructive pulmonary disease (COPD). However, significant variability in adherence exists among patients. This study aimed to identify distinct patterns of inhaled medication adherence and their influencing factors using latent class analysis.

Methods:

A total of 621 inpatients with COPD (85.3% men) hospitalised at a tertiary hospital between September and December 2023 were enrolled. Inhaled medication adherence was evaluated using the Chinese version of the Test of Adherence to Inhalers (TAI). Medication knowledge and beliefs were measured using a self-administered questionnaire. Latent class analysis based on TAI scores, along with multinomial logistic regression, was used to explore factors influencing inhalation medication adherence.

Results:

Three adherence classes were identified: poor adherence (13.9%), moderate adherence (28.8%) and good adherence (57.3%). Significant differences among these groups were found in treatment payment methods, income sources, duration of inhaled drug use, frequency of drug usage, number of disease-related hospital visits in the past 2 years, self-care ability and scores on the medication knowledge and belief questionnaires.

Conclusions:

Distinct adherence patterns exist among patients with COPD, influenced by socioeconomic and behavioural factors. These findings highlight the need for targeted intervention programmes based on adherence profiles to improve inhaled medication adherence in patients with COPD.