Difference between asthma and COPD patients in adherence and non-adherence patterns to inhaler devices

According to the different sociodemographic characteristics of asthma and COPD patients, the adherence to inhaled drugs could also be different. However, there are no studies prospectively evaluating the inhaler adherence in large samples of asthma and COPD patients in the same trial. Objective: To determine the differences between asthma and COPD patients in adherence and non-adherence patterns to inhaled therapy with the Test of the Adherence to Inhalers (TAI). Methods: A total of 910 (500 [55%] asthma and 410 [45%] COPD) patients were included in a cross-sectional observational multicenter study. Participants completed questions about sociodemographics, cultural level, asthma or COPD history, TAI, Morisky-Green test, Asthma Control Test (ACT), COPD Assessment Test (CAT) and recorded spirometry. Results: Patients of the asthma group were significantly women and younger, had higher educational level, active working status, less smokers and more frequently controlled disease with a better pulmonary function than patients of the COPD group. However, they were less adherents (in 10-items TAI), 140 (28%) front 201 (49%), respectively, and they were more frequently erratic (46.4 vs 34.9%) and deliberated (66.8 vs 47.1%) non-adherents, but unwitting non-adherence pattern was more frequent in COPD group (31.2 vs 22.8%). Conclusions: Even though asthma patients have a more favourable sociodemographic and clinical characteristics, they are more non-adherents than COPD patients and exhibit a different pattern of non-adherence type. These points should be considered in the specific educational programs of each disease.