Treatment adherence and health outcomes in patients with bronchiectasis

Amanda R. McCullough, Michael M. Tunney, Alexandra Quittner, J. S. Elborn, Judy M. Bradley, Carmel M. Hughes

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: We aimed to determine adherence to inhaled antibiotics, other respiratory medicines and airway clearance and to determine the association between adherence to these treatments and health outcomes (pulmonary exacerbations, lung function and Quality of Life Questionnaire-Bronchiectasis [QOL-B]) in bronchiectasis after 12 months.Methods: Patients with bronchiectasis prescribed inhaled antibiotics for Pseudomonas aeruginosa infection were recruited into a one-year study. Participants were categorised as " adherent" to medication (medication possession ratio ≥80% using prescription data) or airway clearance (score ≥80% in the Modified Self-Reported Medication-Taking Scale). Pulmonary exacerbations were defined as treatment with a new course of oral or intravenous antibiotics over the one-year study. Spirometry and QOL-B were completed at baseline and 12 months. Associations between adherence to treatment and pulmonary exacerbations, lung function and QOL-B were determined by regression analyses.Results: Seventy-five participants were recruited. Thirty-five (53%), 39 (53%) and 31 (41%) participants were adherent to inhaled antibiotics, other respiratory medicines, and airway clearance, respectively. Twelve (16%) participants were adherent to all treatments. Participants who were adherent to inhaled antibiotics had significantly fewer exacerbations compared to non-adherent participants (2.6 vs 4, p = 0.00) and adherence to inhaled antibiotics was independently associated with having fewer pulmonary exacerbations (regression co-efficient = -0.51, 95% CI [-0.81,-0.21], p < 0.001). Adherence to airway clearance was associated with lower QOL-B Treatment Burden (regression co-efficient = -15.46, 95% CI [-26.54, -4.37], p < 0.01) and Respiratory Symptoms domain scores (regression co-efficient = -10.77, 95% CI [-21.45; -0.09], p < 0.05). There were no associations between adherence to other respiratory medicines and any of the outcomes tested. Adherence to treatment was not associated with FEV1 % predicted.Conclusions: Treatment adherence is low in bronchiectasis and affects important health outcomes including pulmonary exacerbations. Adherence should be measured as part of bronchiectasis management and future research should evaluate bronchiectasis-specific adherence strategies.

Original languageEnglish
Article number107
JournalBMC Pulmonary Medicine
Volume14
Issue number1
DOIs
StatePublished - Jul 1 2014

Fingerprint

Bronchiectasis
Health
Lung
Anti-Bacterial Agents
Pulmonary Medicine
Quality of Life
Therapeutics
Pseudomonas Infections
Spirometry
Pseudomonas aeruginosa
Prescriptions
Regression Analysis
Surveys and Questionnaires

Keywords

  • Bronchiectasis
  • Drug therapy
  • Patient adherence
  • Physical therapy
  • Quality of Life Questionnaire-Bronchiectasis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

McCullough, A. R., Tunney, M. M., Quittner, A., Elborn, J. S., Bradley, J. M., & Hughes, C. M. (2014). Treatment adherence and health outcomes in patients with bronchiectasis. BMC Pulmonary Medicine, 14(1), [107]. https://doi.org/10.1186/1471-2466-14-107

Treatment adherence and health outcomes in patients with bronchiectasis. / McCullough, Amanda R.; Tunney, Michael M.; Quittner, Alexandra; Elborn, J. S.; Bradley, Judy M.; Hughes, Carmel M.

In: BMC Pulmonary Medicine, Vol. 14, No. 1, 107, 01.07.2014.

Research output: Contribution to journalArticle

McCullough, AR, Tunney, MM, Quittner, A, Elborn, JS, Bradley, JM & Hughes, CM 2014, 'Treatment adherence and health outcomes in patients with bronchiectasis', BMC Pulmonary Medicine, vol. 14, no. 1, 107. https://doi.org/10.1186/1471-2466-14-107
McCullough AR, Tunney MM, Quittner A, Elborn JS, Bradley JM, Hughes CM. Treatment adherence and health outcomes in patients with bronchiectasis. BMC Pulmonary Medicine. 2014 Jul 1;14(1). 107. https://doi.org/10.1186/1471-2466-14-107
McCullough, Amanda R. ; Tunney, Michael M. ; Quittner, Alexandra ; Elborn, J. S. ; Bradley, Judy M. ; Hughes, Carmel M. / Treatment adherence and health outcomes in patients with bronchiectasis. In: BMC Pulmonary Medicine. 2014 ; Vol. 14, No. 1.
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N2 - Background: We aimed to determine adherence to inhaled antibiotics, other respiratory medicines and airway clearance and to determine the association between adherence to these treatments and health outcomes (pulmonary exacerbations, lung function and Quality of Life Questionnaire-Bronchiectasis [QOL-B]) in bronchiectasis after 12 months.Methods: Patients with bronchiectasis prescribed inhaled antibiotics for Pseudomonas aeruginosa infection were recruited into a one-year study. Participants were categorised as " adherent" to medication (medication possession ratio ≥80% using prescription data) or airway clearance (score ≥80% in the Modified Self-Reported Medication-Taking Scale). Pulmonary exacerbations were defined as treatment with a new course of oral or intravenous antibiotics over the one-year study. Spirometry and QOL-B were completed at baseline and 12 months. Associations between adherence to treatment and pulmonary exacerbations, lung function and QOL-B were determined by regression analyses.Results: Seventy-five participants were recruited. Thirty-five (53%), 39 (53%) and 31 (41%) participants were adherent to inhaled antibiotics, other respiratory medicines, and airway clearance, respectively. Twelve (16%) participants were adherent to all treatments. Participants who were adherent to inhaled antibiotics had significantly fewer exacerbations compared to non-adherent participants (2.6 vs 4, p = 0.00) and adherence to inhaled antibiotics was independently associated with having fewer pulmonary exacerbations (regression co-efficient = -0.51, 95% CI [-0.81,-0.21], p < 0.001). Adherence to airway clearance was associated with lower QOL-B Treatment Burden (regression co-efficient = -15.46, 95% CI [-26.54, -4.37], p < 0.01) and Respiratory Symptoms domain scores (regression co-efficient = -10.77, 95% CI [-21.45; -0.09], p < 0.05). There were no associations between adherence to other respiratory medicines and any of the outcomes tested. Adherence to treatment was not associated with FEV1 % predicted.Conclusions: Treatment adherence is low in bronchiectasis and affects important health outcomes including pulmonary exacerbations. Adherence should be measured as part of bronchiectasis management and future research should evaluate bronchiectasis-specific adherence strategies.

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