Adherence to inhalatory treatment among children and adolescents with cystic fibrosis: a five-year follow-up study
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2025.215831Keywords:
Cystic fibrosis, Adherence, Inhalation therapy, Lung function, Pulmonary exacerbationAbstract
Introduction: Low adherence to drug treatment has negative effects on the quality of life and health of patients with cystic fibrosis (CF). Previous studies have reported a correlation between poor adherence to treatment and a decline in lung function, pulmonary exacerbations, and hospitalizations. Objective: To evaluate the long-term adherence to inhaled mucolytic treatment among patients with CF treated at João Paulo II Children's Hospital by collecting empty ampoules over a five-year period of follow-up and examining the relationship between the treatment adherence rate and clinical variables. Method: This retrospective analytical longitudinal study of adherence to drug treatment over a five-year period collected data regarding lung function (% of predicted FEV1), clinical signs of exacerbation, body mass index (BMI) Z-score, and dornase alfa medication possession rate (MPR) from the medical records. The MPR was calculated by dividing the number of ampoules returned by the number of prescribed ampoules of alpha dornase. Results: The MPR of dornase alfa indicated an increase in the adherence rate of the 26 patients assessed in this study. The MPR of dornase alfa exhibited no associations with signs of pulmonary exacerbation, use of oral antibiotics, or the BMI/Age Z-Score over the five-year period. Notably, the MPR regression model revealed that a 1% increase in FEV1 required a 0.5% increase in the MPR of dornase alfa. Thus, an improvement in FEV1 is directly related to increased medication use. Conclusion: Requesting the return of empty ampoules of dornase alfa improved adherence rates and lung function over time.
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Copyright (c) 2025 Evanirso da Silva Aquino , Ana Carolina Pena, Letícia Santos Ferreira do Nascimento, Alberto Andrade Vergara, Diego Campos de Moura, Cristiane Cenachi Coelho
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Pontifícia Universidade Católica de Minas Gerais
Grant numbers FIP 2023/28980
