Adherence to Inhalation Therapy Among COPD Patients: A Cross-Sectional Study in a Tertiary Hospital in Quito, Ecuador.

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of death globally, poses a significant public health burden. Despite its high prevalence, underdiagnosis and poor treatment adherence remain major challenges, contributing to increased hospitalization and mortality.

Purpose: This study aimed to assess adherence to inhalation therapy among COPD patients treated at a specialty hospital in Quito, Ecuador.

Patients and methods: A cross-sectional study was conducted on 85 patients diagnosed with COPD at a tertiary hospital in Quito. Data was collected through face-to-face surveys, utilizing the TAI-10 questionnaire to assess treatment adherence, along with demographic and clinical characteristics of the patients.

Results: Among the participants, 34.1% demonstrated good adherence to inhalation therapy, while 32.9% exhibited intermediate adherence, and 32.9% were non-adherent. The majority were older adults aged ≥76 years (67.1%) with a high prevalence of comorbidities (91.8%), particularly hypertension (58.8%). Non-adherence was primarily associated with forgetfulness and financial constraints. Higher BMI was significantly linked to better adherence, with obese patients showing higher odds of intermediate (OR=7.228, 95% CI 1.866-27.996) and good adherence (OR=9.966, 95% CI 2.538-39.139).

Conclusion: Approximately one-third of COPD patients in Ecuador demonstrate good adherence to inhalation therapy, while similar proportions show intermediate or poor adherence. Predominantly older adults and retirees with comorbidities, the population identified forgetfulness and financial constraints as key barriers. These findings emphasize the need for enhanced patient education, regular follow-ups, and tailored support for vulnerable groups.