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Impact of patient satisfaction with his or her inhaler on adherence and asthma control

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Asthma guidelines recommend considering patient preferences for inhaler choice. However, few studies have assessed the impact of patient satisfaction with an inhaler on adherence and health outcomes.


To assess the impact of patient satisfaction with an inhaler on adherence and health outcomes in asthma.


In a cross-sectional, observational, multicenter study, 778 patients with moderate or severe asthma and who were treated with maintenance inhalers completed a number of scales and questionnaires: the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire, the Treatment Satisfaction Questionnaire for Medication, the Test of Adherence to Inhalers (TAI), the Morisky-Green questionnaire, and the Asthma Control Test (ACT).


The study population was categorized according to a median FSI-10 score as high (49.4%) and low (50.6%) satisfaction with their inhaler. Logistic regression analysis showed that high specific satisfaction with an inhaler was associated with the younger age group (odds ratio [OR] 0.976 [95% confidence interval {CI} 0.965‐0.987]); male gender (OR 1.725 [95% CI 1.187‐2.507]); controlled asthma: ACT score ≥ 20 (OR 1.664 [95% CI 1.133‐2.445]); high general satisfaction with treatment (OR 4.861 [95% CI 3.335‐7.085]); high adherence to inhaler: TAI score ≥ 46 (OR 1.546 [95% CI 1.025‐2.332]); nonsevere asthma (OR 1.056 [95% CI 0.648‐1.721]); and no trouble with inhaler use (OR 0.401 [95% CI 0.174‐0.922]).


High patient satisfaction with an inhaler, irrespective of received medication, was related to adherence and asthma control. Our results pointed out the relevance of inhaler choice in inhaled therapy; these results could be useful for designing new strategies targeted to increase adherence in patients with asthma.

Keywords: Asthma; adherence; adults; asthma control; dry powder inhaler; inhaled therapy; inhaler choice; pressurized metered-dose inhaler; satisfaction with inhaler; satisfaction with medication

Document Type: Research Article

Affiliations: 1: From the Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Barcelona, Spain 2: Pulmonary Department, Hospital Clínico San Carlos, Department of Medicine, Faculty of Medicine, University Complutense of Madrid, Institute of Biomedical Research, Hospital Clínico San Carlos, Madrid, Spain 3: Orion Corporation Orion Pharma, Espoo, Finl 4: Orion Pharma, Madrid, Spain 5: Servicio de Neumología y Alergia, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias, Barcelona, Spain

Publication date: November 1, 2018

This article was made available online on October 18, 2018 as a Fast Track article with title: "Impact of patient satisfaction with his or her inhaler on adherence and asthma control".

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

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    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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