• Vicente Plaza, Concepción Fernández-Rodríguez, Carlos Melero, Borja G Cosío, Luís Manuel Entrenas, de Llano Luis Pérez LP 6 Pulmonology Department, Hospital Universitario Lucus Augusti. Lugo , Spain ., Fernando Gutiérrez-Pereyra, Eduard Tarragona, Rosa Palomino, Antolín López-Viña, and TAI Study Group.
• 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau) , Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
• J Aerosol Med Pulm Drug Deliv. 2016 Apr 1; 29 (2): 142-52.

BackgroundTo validate the 'Test of Adherence to Inhalers' (TAI), a 12-item questionnaire designed to assess the adherence to inhalers in patients with COPD or asthma.MethodsA total of 1009 patients with asthma or COPD participated in a cross-sectional multicenter study. Patients with electronic adherence ≥80% were defined as adherents. Construct validity, internal validity, and criterion validity were evaluated. Self-reported adherence was compared with the Morisky-Green questionnaire.ResultsFactor analysis study demonstrated two factors, factor 1 was coincident with TAI patient domain (items 1 to 10) and factor 2 with TAI health-care professional domain (items 11 and 12). The Cronbach's alpha was 0.860 and the test-retest reliability 0.883. TAI scores correlated with electronic adherence (ρ=0.293, p=0.01). According to the best cut-off for 10 items (score 50, area under the ROC curve 0.7), 569 (62.5%) patients were classified as non-adherents. The non-adherence behavior pattern was: erratic 527 (57.9%), deliberate 375 (41.2%), and unwitting 242 (26.6%) patients. As compared to Morisky-Green test, TAI showed better psychometric properties.ConclusionsThe TAI is a reliable and homogeneous questionnaire to identify easily non-adherence and to classify from a clinical perspective the barriers related to the use of inhalers in asthma and COPD.

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