Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease

Soo Jin Kim; Yong Soon Shin

doi:10.7475/kjan.2015.27.6.665

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Kim and Shin: Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease

Original Article

Korean Journal of Adult Nursing 2015; 27(6): 665-672.

Published online: 31 December 2015

DOI: https://doi.org/10.7475/kjan.2015.27.6.665

Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease

Soo Jin Kim¹, Yong Soon Shin²

¹Division of Nursing, Hanyang University Medical Center Seoul Hospital, Seoul, Korea.

²College of Nursing, Hanyang University, Seoul, Korea.

Corresponding author: Shin, Yong Soon. College of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. Tel: +82-2-2220-0798, Fax: +82-2-2220-1163, ysshin2k@hanyang.ac.kr

Received 9 September 2015 Revised 27 November 2015 Accepted 2 December 2015

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease.

Methods

We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses.

Results

Older adults (≥65) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, χ²=14.06, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers.

Conclusion

Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

Keywords: Prescription drug misuse, Metered dose inhalers, Lung disease obstructive, Age groups

Figures and Tables

Table 1

General and Disease-related Characteristics of the Participants (N=150)

COPD=Chronic Obstructive Pulmonary Disease; ACOS=Asthma-COPD Overlap Syndrome; MDI=Metered dose inhaler; DPI=Dry powder inhaler; SMI=Soft mist inhaler; ^†Multiple responses cross tabulation; ^‡Calculated by Mann-Whitney U test.

Table 2

Inhaler Competency and Medication Adherence in Older Adults and Adults (N=150)

^†Calculated by Mann-Whitney U test.

Table 3

Difference of Inhaler Competency between Adherent and Nonadherent (N=150)

Table 4

Association between Inhaler Competency and Medication Adherence (N=150)

^†Calculated by Spearman correlation coefficient.

Notes

This manuscript is based on a part of the first author's master's thesis from Hanyang University.

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