Predictors of Adherence to Inhaled Medications

Authors Reply—We appreciate Dr. Schattner’s comment on our work. We believe our study ¹ adds to the field by showing that a patient’s adherence to one of their inhaled medications for chronic obstructive pulmonary disease (COPD) is not predictive of adherence to their other COPD medications. The finding that patients are not adherent to their inhalers is important information for both providers discussing medication usage with their patients and for researchers designing future studies of inhaler adherence.

Dr. Schattner is correct that our study was unable to provide an explanation for patients’ discordant adherence to their COPD medications. He suggests that the nature of the patient–physician interaction may be an important determinant of medication adherence. Cecere et al. demonstrated that patient perception of clinician expertise in lung disease was a strong predictor of adherence to inhaled medications for COPD.² Additionally, satisfaction with and faith in their doctor were significant predictors of medication adherence in patients with COPD.³ We agree that other features of the patient–physician interaction may be important determinants of medication adherence, both in COPD and in other chronic illnesses, and that further studies should assess which aspects of the patient–physician interaction have a significant impact on adherence.