Article Text


Interstitial lung disease: epidemiology, care and survival
P209 Impact of Patient Satisfaction with Their Maintenance Inhaler on Treatment Compliance and Health Outcomes in Chronic Obstructive Pulmonary Disease: An Analysis of Real-World Clinical Practise in Europe
  1. H Chrystyn1,
  2. M Small2,
  3. G Milligan2,
  4. V Higgins3,
  5. E Garcia Gil4,
  6. C Karakurum4
  1. 1University of Huddersfield, Huddersfield, UK
  2. 2Adelphi Real World, Macclesfield, UK
  3. 3Adelphi Real World, New York, NY, USA
  4. 4Almirall SA, Barcelona, Spain


Introduction and objective Compliance with prescribed treatment is often suboptimal in patients with chronic obstructive pulmonary disease (COPD). This analysis examined the relationships between inhaler satisfaction, compliance and health outcomes.

Methods Data were analysed from a large, cross-sectional survey of real-world clinical practise conducted in five European countries. Respiratory specialists and primary care physicians provided information on six consecutive patients with COPD (aged ≥40 years with history of smoking). The same patients were then asked to voluntarily complete a self-assessment form. Physicians scored patient compliance with prescribing instructions (5-point Likert scale: 1=‘not at all compliant’; 5=‘fully compliant’) and patients rated overall satisfaction with their maintenance inhaler (7point Likert scale: 1=‘not at all satisfied’; 7=‘very satisfied’). Health outcomes assessments included exacerbations, the modified Medical Research Council dyspnoea scale, the EuroQoL (EQ-5D) instrument and the Jenkins Sleep Questionnaire. Sequential regression was used to analyze the relationship between inhaler attributes and overall satisfaction. Least-squares regression and additive models were used to analyze the relationships between inhaler satisfaction, compliance and health outcomes.

Results Data were included for 1443 patients for whom self-completed and matched physician-completed record forms were available. The majority of patients (71.8%) were male; mean age was 65.2 years. Very few patients (0.7%) were ‘not at all compliant’ with their physician’s prescribing instructions, whilst 33.3% were ‘fully compliant’. Most patients (75.1%) were more satisfied with their inhaler than not; 6.6% were ‘very satisfied’. Key attributes influencing satisfaction related to durability, ergonomics and ease of use. There was a significant association between inhaler satisfaction and compliance (χ2 − df=89.7; p<0.001). Other factors related to greater compliance, though to a lesser degree, were fewer maintenance drugs (χ2 − df=17.7; p<0.001) and male gender (χ2 − df=2.9; p<0.05). Severity of breathlessness, age and ethnicity were not significantly associated with compliance (p>0.05). Higher compliance scores were significantly associated with better health outcomes (Table). There was also a direct association between inhaler satisfaction and better health outcomes (exacerbations and EQ-5D, p<0.001).

Abstract P209 Table 1

Conclusions Inhaler satisfaction appears to be significantly associated with COPD treatment compliance, and patients with greater compliance experience better health outcomes, including less frequent exacerbations.

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.