TRENDS IN COMPLIANCE WITH BRONCHODILATOR INHALER USE BETWEEN FOLLOW-UP VISITS IN A CLINICAL-TRIAL

Study objective: To assess objectively measured, long-term trends in c ompliance with physician-prescribed metered-dose inhaler (MDI) use dur ing a clinical trial. Design: A prospective study. Setting: The Lung H ealth Study, a 5-year clinical trial to determine the effect of specia l intervention with an intensive smoking cessation program and broncho dilator therapy in cigarette smokers 35 to 60 years of age with minima l to moderate airflow limitation due to COPD. Participants: Two hundre d thirty-one participants who were issued an MDI with an attached Nebu lizer Chronolog (NC) (Forefront Technologies Inc; Lakewood, Cole) whic h electronically records the date and time of each MDI actuation, One hundred two participants were not informed of the recording capabiliti es of the attached NC, while 129 participants were aware of the NC's m onitoring function. Intervention: Following an initial 12-week period of counseling, participants returned to the clinic every 4 months. Mea surements and results: Analysis of the data from the NC collected over a period of 2 years indicates that compliance with the prescribed med ication regimen was best immediately following each follow-up visit an d gradually declined during the interval between follow-up visits. The level of compliance after each visit was lower for each successive fo llow-up. These trends could not be observed from self-report or weighi ng the medication canisters at follow-up visits. The participants who were informed of the NC's function and who were provided with detailed feedback about their inhaler use generally showed better compliance.