Editorial
Test of Adherence to Inhalers
El test de adhesión a los inhaladores
Vicente Plazaa,
, Antolín López-Viñab, Borja G. Cosioc,d, in representation of the Comité Científico del Proyecto TAI
Corresponding author
a Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Departament de Medicina, Barcelona, Spain
b Servicio de Neumología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain
c Servicio de Neumología, Hospital Son Espases-IdISPa, Palma de Mallorca, Islas Baleares, Spain
d CIBER Enfermedades Respiratorias (CIBERES)
Read
8867
Timeswas read the article
3801
Total PDF
5066
Total HTML
Share statistics
array:24 [ "pii" => "S1579212917300824" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.03.005" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1452" "copyright" => "SEPAR" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:360-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2692 "formatos" => array:3 [ "EPUB" => 126 "HTML" => 1287 "PDF" => 1279 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289616302344" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.08.006" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1452" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:360-1" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4900 "formatos" => array:3 [ "EPUB" => 113 "HTML" => 3608 "PDF" => 1179 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "El test de adhesión a los inhaladores" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "360" "paginaFinal" => "361" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Test of Adherence to Inhalers" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Vicente Plaza, Antolín López-Viña, Borja G. Cosio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Vicente" "apellidos" => "Plaza" ] 1 => array:2 [ "nombre" => "Antolín" "apellidos" => "López-Viña" ] 2 => array:2 [ "nombre" => "Borja G." "apellidos" => "Cosio" ] 3 => array:1 [ "colaborador" => "en representación del Comité Científico del Proyecto TAI" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917300824" "doi" => "10.1016/j.arbr.2017.03.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300824?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302344?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000007/v2_201706291228/S0300289616302344/v2_201706291228/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212917300812" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.03.004" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1451" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:362-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1444 "formatos" => array:3 [ "EPUB" => 149 "HTML" => 930 "PDF" => 365 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Is Chronic Obstructive Pulmonary Disease Really a Progressive Disease?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "362" "paginaFinal" => "363" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Es realmente la enfermedad pulmonar obstructiva crónica una enfermedad progresiva?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan P. de Torres, Bartolome R. Celli" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Juan P." "apellidos" => "de Torres" ] 1 => array:2 [ "nombre" => "Bartolome R." "apellidos" => "Celli" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302332" "doi" => "10.1016/j.arbres.2016.08.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302332?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300812?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917300812/v1_201706290145/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212917300095" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.01.005" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1524" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:357-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1605 "formatos" => array:3 [ "EPUB" => 114 "HTML" => 991 "PDF" => 500 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Exercise Training Versus Neuromuscular Stimulation in Severe COPD" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "357" "paginaFinal" => "359" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Entrenamiento físico frente a estimulación neuromuscular en la EPOC grave" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Matthew Maddocks, Veronica Delogu, Sarah E. Jones, Michael I. Polkey, William D.-C. Man" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Matthew" "apellidos" => "Maddocks" ] 1 => array:2 [ "nombre" => "Veronica" "apellidos" => "Delogu" ] 2 => array:2 [ "nombre" => "Sarah E." "apellidos" => "Jones" ] 3 => array:2 [ "nombre" => "Michael I." "apellidos" => "Polkey" ] 4 => array:2 [ "nombre" => "William D.-C." "apellidos" => "Man" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616303544" "doi" => "10.1016/j.arbres.2016.11.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616303544?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300095?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917300095/v1_201706290145/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Test of Adherence to Inhalers" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "360" "paginaFinal" => "361" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Vicente Plaza, Antolín López-Viña, Borja G. Cosio" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Vicente" "apellidos" => "Plaza" "email" => array:1 [ 0 => "vplaza@santpau.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Antolín" "apellidos" => "López-Viña" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Borja G." "apellidos" => "Cosio" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 3 => array:1 [ "colaborador" => "in representation of the Comité Científico del Proyecto TAI" ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Departament de Medicina, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Son Espases-IdISPa, Palma de Mallorca, Islas Baleares, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "CIBER Enfermedades Respiratorias (CIBERES)" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El test de adhesión a los inhaladores" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The WHO believes low treatment adherence by patients to be a serious global health problem that affects all regions, cultures, ages, and diseases, and rates have remained unchanged in the last 30 years.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Poor therapeutic adherence is associated with higher mortality, frequent exacerbations, worse control, and greater socioeconomic costs, both in asthma<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> and in COPD.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The high clinical impact of the problem has led the authors of the latest clinical practice guidelines on asthma and COPD to emphasize the need to actively identify and actively correct lack of compliance. Simply asking the patient during a clinical visit if he has taken his prescribed treatment will invariably lead to an overestimation of the rate of adherence, so other more reliable methods are recommended. These range from inexpensive techniques that provide immediate results but are less robust (questionnaires, electronic records of prescription collection), to others that are more costly and time consuming, but which give a more accurate estimation of adherence (medication counts/weighing, drug levels in blood, electronic devices recording inhaler use). Complexity and costs mean that the second set of techniques are more usually applied in research, while the first are used in standard clinical practice. The simplest methods are probably self-administered questionnaires. The gold standard is the Morisky–Green, which was designed to evaluate compliance with oral drugs in the treatment of arterial hypertension.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> More recently, the Medication Adherence Rating Scale for Asthma (MRS-A) was developed to determine adherence to inhaled corticosteroids in asthma. This tool was adapted from a questionnaire initially designed to evaluate treatment adherence to oral drugs in depression.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Inhalation drugs, despite being the first choice in the treatment of asthma and COPD, may have some drawbacks. Some of the particular features of inhalers (learning inhalation techniques, different inhalation techniques depending on the device used, manual skills required for use, cultural aspects, etc.) can contribute to poor adherence. These aspects undermine the effectiveness of the standard questionnaires for assessing the use of inhaled medications, as they were designed to measure adherence to oral medications. Thus, in view of the lack of specific questionnaires for inhaled drugs, a group of researchers from the Integrated Asthma and COPD Research Program (PII) of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) designed and validated the Test of Adherence to Inhalers (TAI).<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> This test can be used to identify not only patients with poor adherence, but also to establish the degree of adherence (good, intermediate, poor) and flag the type or pattern of non-compliance (sporadic, deliberate and unconscious), both in asthma and in COPD. It consists of 2 complementary questionnaires: the 10-item TAI, completed by the patient, which identifies patients with poor adherence and their level of adherence, and the 12-item TAI, completed by the patient and the health professional, which flags the pattern of non-compliance. The questionnaire for standard clinical practice can be downloaded free of charge from <a href="http://www.taitest.com/">http://www.taitest.com</a>, and permission to use the test in research can be requested on the same website.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The validation study, conducted in 1009 patients (500 asthmatics and 410 COPD patients; and a control group of 99 asthmatics in whom adherence was measured with electronic devices), showed that the TAI has good psychometric properties (reliable, homogeneous, and unidimensional), excellent internal validity (Cronbach's alpha=0.873), and a test–retest reliability of 0.883.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Compared to the Morisky–Green test, TAI showed a slight, but significantly better (<span class="elsevierStyleItalic">P</span><.05) correlation with adherence determined using Smartinhaler<span class="elsevierStyleSup">®</span> electronic devices (<span class="elsevierStyleItalic">ρ</span>=0.286 vs <span class="elsevierStyleItalic">ρ</span>=0.247). It also revealed other interesting results when the 2 patient groups were compared: the prevalence of good adherence was significantly greater in COPD (49%) than in asthma (28%); and COPD patients had a significantly higher proportion of unconscious non-compliance, and a lower rate of sporadic errors than asthmatics.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The fact that the TAI also gives an idea of the non-compliance pattern is an additional advantage over other questionnaires not specifically designed for inhalers. Logically, the correction of sporadic errors (dosing reminder tools, probably managed via e-medicine<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>) will be very different from correction of deliberate (motivational interview<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>) or unintended non-compliance (personalized program and reiteration of educational messages).</p><p id="par0030" class="elsevierStylePara elsevierViewall">The questionnaire has been rapidly and widely accepted in Spain and abroad, and validation studies in the main European languages will be undertaken shortly. A Spanish multicenter study was launched recently (RE-TAI Project), which aims to determine if combining the results obtained from the TAI with an electronic registry of prescription collection will improve its ability to identify deficient adherence. The results of a preliminary pilot study conducted in a small sample of patients tended to support this premise.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The reliability of information provided by the TAI (and self-administered questionnaires in general) has been questioned, since patients can falsify their responses to conceal a possible lack of adherence. Although this is a possibility, the TAI validation study<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> confirmed that its results are reasonably reliable when compared with those of the control group (obtained using electronic devices), as mentioned above.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In the current medical scientific era of the “omes” (metabolome, genome, etc.), perhaps we should include the term “adhesome” in the list. Increasing the rate of therapeutic compliance is a key factor in achieving adequate disease control. Instead of developing more effective and safe (and more expensive) molecules, the greatest challenge nowadays may be to achieve better therapeutic adherence among our patients. The first step is to measure adherence, and to this end, the TAI is an inexpensive, immediate and reasonably reliable tool that can be used to flag non-compliance patterns, and to guide subsequent specific corrective action.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">The TAI Project was funded by <span class="elsevierStyleGrantSponsor" id="gs1">Chiesi Spain</span>.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of Interests</span><p id="par0050" class="elsevierStylePara elsevierViewall">In relation with this publication, the authors (VP, ALV and BGC) state that they have received fees as members of the Scientific Committee of the Chiesi TAI Project.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of Interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Plaza V, López-Viña A, Cosio BG, en representación del Comité Científico del Proyecto TAI. El test de adhesión a los inhaladores. Arch Bronconeumol. 2017;53:360–361.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Ginebra (Suiza). ISBN 9241545992" "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Adherence to long-term therapies: evidence for action" "serieFecha" => "2003" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medication adherence and the risk of severe asthma exacerbations: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Engelkes" 1 => "H.M. Janssens" 2 => "J.C. de Jongste" 3 => "M.C. Sturkenboom" 4 => "K.M. Verhamme" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00075614" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2015" "volumen" => "45" "paginaInicial" => "396" "paginaFinal" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25323234" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adherence to inhaled therapy, mortality and hospital admission in COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Vestbo" 1 => "J.A. Anderson" 2 => "P.M. Calverley" 3 => "B. Celli" 4 => "G.T. Ferguson" 5 => "C. Jenkins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2009.113662" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2009" "volumen" => "64" "paginaInicial" => "939" "paginaFinal" => "943" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19703830" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Concurrent and predictive validity of a self-reported measure of medication adherence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.E. Morisky" 1 => "L.W. Green" 2 => "D.M. Levine" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "1986" "volumen" => "24" "paginaInicial" => "67" "paginaFinal" => "74" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3945130" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessing the validity of self-reported medication adherence among inner-city asthmatic adults: the Medication Adherence Report Scale for Asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Cohen" 1 => "D.M. Mann" 2 => "J.P. Wisnivesky" 3 => "R. Horne" 4 => "H. Leventhal" 5 => "T.J. Musumeci-Szabó" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Allergy Asthma Immunol" "fecha" => "2009" "volumen" => "103" "paginaInicial" => "325" "paginaFinal" => "331" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19852197" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of the ‘Test of the Adherence to Inhalers’ (TAI) for asthma and COPD patients" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "on behalf of the TAI Study Group" "etal" => true "autores" => array:6 [ 0 => "V. Plaza" 1 => "C. Fernández-Rodríguez" 2 => "C. Melero" 3 => "B.G. Cosío" 4 => "L.M. Entrenas" 5 => "L. Pérez de Llano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/jamp.2015.1212" "Revista" => array:6 [ "tituloSerie" => "J Aerosol Med Pulm Drug Deliv" "fecha" => "2016" "volumen" => "29" "paginaInicial" => "142" "paginaFinal" => "152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26230150" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differences in adherence and non-adherence behaviour patterns to inhaler devices between COPD and asthma patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Plaza" 1 => "A. López-Viña" 2 => "L.M. Entrenas" 3 => "C. Fernández-Rodríguez" 4 => "C. Melero" 5 => "L. Pérez-Llano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J COPD" "fecha" => "2016" "volumen" => "20" "paginaInicial" => "1" "paginaFinal" => "8" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "pii:S0300-2896(16)30172-7 [article in English, Spanish]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pros and cons of telemedicine in the management of patients with chronic respiratory diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Segrelles-Calvo" 1 => "D. López-Padilla" 2 => "J.I. de Granda-Orive" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2016.05.016" "Revista" => array:2 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2016" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A study of a multi-level intervention to improve non-adherence in difficult to control asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Gamble" 1 => "M. Stevenson" 2 => "L.G. Heaney" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2011.03.019" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2011" "volumen" => "105" "paginaInicial" => "1308" "paginaFinal" => "1315" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21511454" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluación de la adhesión terapéutica a los inhaladores en pacientes con asma mediante el registro electrónico de retirada de fármacos en Farmacia y el TAI (Test de Adhesión a los Inhaladores). Estudio preliminar Proyecto RETAI" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Giner" 1 => "M. Torrejón" 2 => "M. Peiró" 3 => "F. Gutiérrez" 4 => "E. Tarragona" 5 => "V. Plaza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0300-2896(16)30197-1" "Revista" => array:7 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2016" "volumen" => "52" "numero" => "Espec Cong 1" "paginaInicial" => "1" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27389766" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Acknowledgements" "texto" => "<p id="par0055" class="elsevierStylePara elsevierViewall">We thank the other members of the Scientific Committee of the Chiesi TAI Project (Drs. Luisma Entrenas, Concha Fernández-Rodríguez, Carlos Melero, Rosa Palomino, Luis Pérez de Llano and Eduard Tarragona), researchers on the TAI validation study. We also thank Chiesi Spain.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917300824/v1_201706290145/en/main.assets" "Apartado" => array:4 [ "identificador" => "46447" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000007/v1_201706290145/S1579212917300824/v1_201706290145/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300824?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 23 | 7 | 30 |
| 2024 October | 263 | 73 | 336 |
| 2024 September | 204 | 51 | 255 |
| 2024 August | 130 | 53 | 183 |
| 2024 July | 124 | 37 | 161 |
| 2024 June | 196 | 51 | 247 |
| 2024 May | 181 | 35 | 216 |
| 2024 April | 111 | 40 | 151 |
| 2024 March | 134 | 28 | 162 |
| 2024 February | 41 | 21 | 62 |
| 2023 May | 1 | 0 | 1 |
| 2023 March | 19 | 8 | 27 |
| 2023 February | 81 | 46 | 127 |
| 2023 January | 67 | 58 | 125 |
| 2022 December | 63 | 50 | 113 |
| 2022 November | 70 | 39 | 109 |
| 2022 October | 65 | 56 | 121 |
| 2022 September | 52 | 35 | 87 |
| 2022 August | 70 | 59 | 129 |
| 2022 July | 61 | 60 | 121 |
| 2022 June | 55 | 32 | 87 |
| 2022 May | 65 | 84 | 149 |
| 2022 April | 69 | 84 | 153 |
| 2022 March | 66 | 116 | 182 |
| 2022 February | 52 | 51 | 103 |
| 2022 January | 72 | 76 | 148 |
| 2021 December | 86 | 71 | 157 |
| 2021 November | 72 | 69 | 141 |
| 2021 October | 73 | 79 | 152 |
| 2021 September | 58 | 74 | 132 |
| 2021 August | 66 | 73 | 139 |
| 2021 July | 60 | 58 | 118 |
| 2021 June | 58 | 59 | 117 |
| 2021 May | 79 | 63 | 142 |
| 2021 April | 154 | 136 | 290 |
| 2021 March | 117 | 73 | 190 |
| 2021 February | 50 | 51 | 101 |
| 2021 January | 63 | 63 | 126 |
| 2020 December | 49 | 46 | 95 |
| 2020 November | 65 | 48 | 113 |
| 2020 October | 58 | 44 | 102 |
| 2020 September | 59 | 31 | 90 |
| 2020 August | 44 | 30 | 74 |
| 2020 July | 48 | 49 | 97 |
| 2020 June | 40 | 28 | 68 |
| 2020 May | 45 | 25 | 70 |
| 2020 April | 49 | 50 | 99 |
| 2020 March | 33 | 32 | 65 |
| 2020 February | 65 | 49 | 114 |
| 2020 January | 51 | 46 | 97 |
| 2019 December | 78 | 56 | 134 |
| 2019 November | 64 | 55 | 119 |
| 2019 October | 49 | 666 | 715 |
| 2019 September | 56 | 28 | 84 |
| 2019 August | 38 | 32 | 70 |
| 2019 July | 50 | 21 | 71 |
| 2019 June | 37 | 17 | 54 |
| 2019 May | 69 | 36 | 105 |
| 2019 April | 74 | 39 | 113 |
| 2019 March | 59 | 23 | 82 |
| 2019 February | 35 | 29 | 64 |
| 2019 January | 43 | 24 | 67 |
| 2018 December | 30 | 21 | 51 |
| 2018 November | 89 | 33 | 122 |
| 2018 October | 159 | 25 | 184 |
| 2018 September | 24 | 13 | 37 |
| 2018 May | 22 | 0 | 22 |
| 2018 April | 38 | 5 | 43 |
| 2018 March | 29 | 5 | 34 |
| 2018 February | 28 | 7 | 35 |
| 2018 January | 24 | 9 | 33 |
| 2017 December | 36 | 24 | 60 |
| 2017 November | 36 | 23 | 59 |
| 2017 October | 22 | 12 | 34 |
| 2017 June | 0 | 1 | 1 |
Show all
