Inhaler Adherence in COPD and Its Clinical and Contextual Associations: A Single-Center Cross-Sectional Study

Purpose: Effective management of chronic obstructive pulmonary disease (COPD) depends on sustained adherence to inhaled therapies, yet real-world factors associated with inhaler adherence and disease awareness are not fully characterized. This study aimed to evaluate inhaler medication adherence among patients with COPD and to explore its associations with sociodemographic, clinical, and contextual factors, including self-reported disease awareness. Patients and Methods: This single-center, cross-sectional descriptive study was conducted between July and October 2025 in the Chest Diseases Outpatient Clinic of a tertiary hospital. Patients aged ≥18 years with a confirmed diagnosis of COPD based on GOLD 2025 criteria were included. Sociodemographic and clinical data were collected using structured, interviewer-administered questionnaires. Inhaler adherence was assessed using a structured questionnaire adapted from the Test of Adherence to Inhalers (TAI). Symptom burden and dyspnea were evaluated using the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) dyspnea scale, respectively. Statistical analyses were performed using IBM SPSS Statistics version 23.0, with a two-sided p value < 0.05 considered statistically significant. Results: A total of 170 patients were included in the analysis (GOLD group A: 31.2%, group B: 44.1%, and group E: 24.7%). Marital status (p = 0.003), family history of COPD (p