Validation of the 'Test of the Adherence to Inhalers' (TAI) for Asthma and COPD Patients

Vicente Plaza, Concepción Fernández-Rodríguez, Carlos Melero, Borja G. Cosío, Luís Manuel Entrenas, Luis Pérez De Llano, Fernando Gutiérrez-Pereyra, Eduard Tarragona, Rosa Palomino, Antolín López-Viña, R. Agüero Balbín, B. Alcázar Navarrete, I. Ali García, C. Almonacid Sánchez, I. Alvaredo Martín, F. Álvarez Navascues, D. Álvaro Álvarez, R. Andujar Espinosa, P. Ansola Zubiaurre, M. Antolín GarcíaA. Arnedillo Muñoz, S. Arranz Alonso, M. Avilés Ingles, M. Badimon Garrido, M. Barcena Caamaño, P. Barranco Sanz, T. Bazús, J. Bioque Rivera, E. Bollo De Miguel, D. Bouza Álvarez, F. Bravo Gutiérrez, E. Burches Baixauli, V. Bustamante Madariaga, C. Cabrera López, M. Calle Rubio, E. Calvo Corbella, A. Capelastegui Saiz, F. Carballada Gonzalez, J. Carretero Gracia, T. Caruana Careaga, F. Casas Maldonado, L. Cassini Gómez De Cádiz, J. Castillo Vizuete, P. Cebollero Rivas, E. Centeno Etxebarrieta, E. Chiner Vives, J. Cimas Hernando, C. Cisneros Serrano, C. Colás Sanz, M. Compán Bueno, A. Conde Valero, F. Contreras Porta, M. Corbacho Abelaira, P. Cordero Montero, J. Costan Galicia, A. De Diego Damiá, E. De Higes Martínez, J. Delgado Romero, C. Diego Roza, F. Diez Fernández, A. Domenech Del Rio, M. Domínguez Álvarez, L. Domínguez Juncal, J. Domínguez Ortega, Luís Manuel Entrenas, M. Espinosa De Los Monteros Garde, C. Estirado Vera, M. Fernández González, E. Fernández Robledo, A. Fernández Tena, A. Fernández Villar, J. Figueira Gonçalves, X. Flor Escriche, J. Florido López, C. Fluixá Carrascosa, J. Galdiz Iturri, J. Garcia De Pedro, M. García Marrón, J. Garcia Rivero, B. García-Cosío, L. García-Giralda Ruíz, A. Gil Adrados, J. Gil Carbonell, B. Gil Marín, M. Gimeno Peribáñez, L. Ginel Mendoza, J. Giner Donaire, R. Godoy Mayoral, M. Gómez Entrena, E. Gómez Torrijos, F. González Barcala, M. González Gutiérrez, A. González López, F. González Vargas, J. Guallar Ballester, V. Gutiérrez Vall De Cabres, M. Hernández Fernández De Rojas, S. Hernández Flix, J. Hueto Pérez De Heredia, J. Igea Aznar

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75 Citations (Scopus)

Abstract

Copyright © 2016 Mary Ann Liebert, Inc. Background: To validate the 'Test of Adherence to Inhalers' (TAI), a 12-item questionnaire designed to assess the adherence to inhalers in patients with COPD or asthma. Methods: A total of 1009 patients with asthma or COPD participated in a cross-sectional multicenter study. Patients with electronic adherence ≥80% were defined as adherents. Construct validity, internal validity, and criterion validity were evaluated. Self-reported adherence was compared with the Morisky-Green questionnaire. Results: Factor analysis study demonstrated two factors, factor 1 was coincident with TAI patient domain (items 1 to 10) and factor 2 with TAI health-care professional domain (items 11 and 12). The Cronbach's alpha was 0.860 and the test-retest reliability 0.883. TAI scores correlated with electronic adherence (ρ=0.293, p=0.01). According to the best cut-off for 10 items (score 50, area under the ROC curve 0.7), 569 (62.5%) patients were classified as non-adherents. The non-adherence behavior pattern was: erratic 527 (57.9%), deliberate 375 (41.2%), and unwitting 242 (26.6%) patients. As compared to Morisky-Green test, TAI showed better psychometric properties. Conclusions: The TAI is a reliable and homogeneous questionnaire to identify easily non-adherence and to classify from a clinical perspective the barriers related to the use of inhalers in asthma and COPD.
Original languageEnglish
Pages (from-to)142-152
JournalJournal of Aerosol Medicine and Pulmonary Drug Delivery
Volume29
Issue number2
DOIs
Publication statusPublished - 1 Apr 2016

Keywords

  • Administration and dosage
  • Chronic obstructive
  • Drug therapy
  • Inhalers
  • Medication adherence
  • Medication non-adherence
  • Pulmonary disease
  • Questionnaires
  • Validation studies
  • anti-asthmatic agents

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