International Journal of Medical Sociology and Anthropology

International Journal of Medical Sociology and Anthropology ISSN 2756-3820 Vol. 12 (2), pp. 001-015, February, 2023. © International Scholars Journals

Full Length Research Paper

Patterns of behavior and adherence to inhalation therapy in patients with COPD

Claudio Micheletto1, Cristiana Bertolucci2, Lucio Corsaro3, Alessio Piraino4 and Gianluca Vaccaro5


1Respiratory Unit, University Hospital Verona, Piazzale Aristide Stefani, 1 – 37126, Verona - Italy

2Chiesi Italia S.p.A. Via Giacomo Chiesi 1 – 43122, Parma - Italy

3Founder & Advisor at Bhave, Via Giambattista Vico 1 – 00196, Rome – Italy

4Medical Affairs, Chiesi Italia S.p.A., Via Giacomo Chiesi 1 – 43122, Parma – Italy

5PhD, Methodological Advisor at Bhave, Via Giambattista Vico 1 – 00196, Rome - Italy; Sociologist UO Education and Health Promotion, Asp Catania, Via Santa Maria la Grande 5 – 95124, Catania, Italy. Corresponding Author email:

Accepted 19 January, 2023


Background: COPD is a leading cause of chronic morbidity and mortality worldwide. For the treatment success it is also necessary to ensure long-term adherence to inhaled drug therapy, whose levels are generally around 50% due to a series of factors involving medication, characteristics of the device system, and patient’s and healthcare professionals’ behaviors. Today important gaps persist in the knowledge of behaviors, beliefs, preferences and self-perceived health status in patients with COPD, as well as in the social, economic or health contextual factors and their possible relationships with adherence to therapy as potential ‘adherence determinants’. Objective: The present research aims to understand patterns of behaviour and type of routines related to the use of different kinds of device (spray or powder) and their possible relationships with the adherence to inhalation therapy in patients with COPD. Methods: CAWI-CATI-FtoF sociological survey with structured questionnaire with standardized scales of measurement of adherence to a specific therapy for COPD, symptoms management and self-perceived health status. Inclusion criteria: patients with medical diagnosis of COPD and currently under inhalation treatment. Percentage shares of prevalent users of MDI, DPI over the years and both such as to guarantee the sub-analysis of clusters. Results: COPD has a significant impact on life for most of the interviewees, in particular for 46% of them it has a high impact and for 15% a very high impact on their life and daily habits. A clear majority of interviewees reported partial (66%) or major (24%) limitations related to their physical health due to their disease, while almost half of the sample of respondents (44%) appears to be poorly adherent to treatment. Conclusions: impact of disease on the interviewee's activity is "high" or "very high" in the clear majority of patients with severe or moderate disease condition and the levels of adherence to therapies are very low. Improving patient adherence to inhalation therapy can lead to a better outcome for COPD treatment, with positive repercussions in terms of disease control, use of health services, positive impact on survival rate, patient’s quality of life and health care costs. 

Key words: COPD, Patient-reported outcomes, inhalation treatment, chronic illness, self-perceived health.