Research Article
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The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases

Year 2026, Volume: 53 Issue: 1, 67 - 75, 10.03.2026
https://doi.org/10.5798/dicletip.1906428
https://izlik.org/JA94LA69ZB

Abstract

Aim: This study aimed to assess adherence to pharmacological and non-pharmacological treatments, hospital stay duration, and related risk factors in patients hospitalized with COPD and asthma exacerbations.
Methods: A cross-sectional study was conducted between January and March 2023, including patients admitted to the chest diseases department with a diagnosis of COPD or asthma exacerbation. Patients with community-acquired pneumonia, without a known diagnosis of asthma or COPD, were used as a control group. A validated questionnaire adapted from Jeong et al. was used to evaluate treatment adherence. The COPD and asthma groups were compared with the control group. T-tests and chi-square tests were used for statistical analysis.
Results: A total of 30 COPD, 12 asthma, and 17 pneumonia patients were included. The overall mean age was 52.9±10.9 years, and 73% were male. COPD patients were significantly older (p=0.04), predominantly male (p<0.001), had a higher smoking history (p=0.02), and lower BMI (p=0.02) than asthma patients. Hospital stay duration and number of exacerbations were similar. Inhaler adherence was low in both COPD (70%) and asthma (66.7%) patients. Nonpharmacological adherence, including vaccination, was also insufficient in all groups.
Conclusion: Although differing in demographics, COPD and asthma patients exhibited similar risk factors and poor treatment adherence. Strategies to improve both pharmacological and non-pharmacological adherence should be integrated into clinical practice to reduce hospitalizations and improve patient outcomes.

Ethical Statement

This study was approved by the local institutional ethics committee under protocol number 116.2017.R-274 and was carried out in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants.

References

  • 1. Global Initiative for A. Global Strategy for Asthma Management and Prevention 2024. 2024.
  • 2. Global Initiative for Chronic Obstructive Lung D. Global Strategy for the Diagnosis, Management, and Prevention of COPD: 2025 Report. 2025.
  • 3. Oh J , K im S , Y im Y, K im MS; G BD 2 023 G lobal Chronic Respiratory Disease and Covid Collaborators; Hay SI, I l S hin J , Y on D K. G lobal, regional, and national burden of chronic respiratory diseases and impact of the COVID-19 pandemic, 1990-2023: a Global Burden of Disease study. Nat Med. 2026 Jan;32(1):197-223.
  • 4. Singh D, Han MK, Bhatt SP. Is disease stability an attainable chronic obstructive pulmonary disease treatment goal? Am J Respir Crit Care Med. 2025;211(3):452-63.
  • 5. Çelik GE, Aydin Ö, Şen E, et al. Asthma–chronic obstructive pulmonary disease overlap: Results from a national multicenter study. Tuberk Toraks. 2024;72(1):25-36.
  • 6. Parasuaraman G, Ayyasamy L, Aune D, et al. The association between body mass index, abdominal fatness, and weight change and the risk of adult asthma: a systematic review and meta-analysis of cohort studies. Sci Rep. 2023;13(1):7745.
  • 7. Xiang, X., Huang, L., Fang, Y. et al. Physical activity and chronic obstructive pulmonary disease: a scoping review. BMC Pulm Med 22, 301 (2022).
  • 8. Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016 Dec 8;12(12):CD005305.
  • 9. Çolak Y., Afzal S., Marott JL., et al. Prognosis of COPD depends on severity of exacerbation history: A population-based analysis. Respir Med. 2019;155:141-7.
  • 10. Jeong H., Kim SH., Choi S., et al. Nonadherence to health promotion depending on chronic obstructive pulmonary disease severity. Heart Lung. 2022; 55:1-10.
  • 11. Mallya SG, Upadhyay A, Psoter KJ, et al. Association between difficulty affording medications and outcomes in chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2025.
  • 12. Koçak C, Polastri M, Pehlivan E. Creating homebased pulmonary rehabilitation programs for patients with asthma: insights from practice. J Yeungnam Med Sci. 2025;42:57.
  • 13. Hyvert S, Yailian AL, Haesebaert J, et al. Association between health literacy and medication adherence in chronic diseases: a recent systematic review. Int J Clin Pharm. 2023;45(1):38-51.
  • 14. Shao Y, Hu H, Liang Y, et al. Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. Patient Educ Couns. 2023 Sep;114:107829.
  • 15. Arismendi E, Ribo P, García A, et al. Asthma Control According to GINA 2023: Does Changing the Criteria Improve Asthma Control? J Clin Med. 2024 Nov 6;13(22):6646.
  • 16. George M, Bender B. New insights to improve treatment adherence in asthma and COPD. Patient Prefer Adherence. 2019 Jul 31;13:1325-1334. doi: 10.2147/PPA.S209532.
  • 17. Pandey AK, Verma AK, Singh A, et al. Management Strategies of COPD during the COVID-19 Pandemic. Tanaffos. 2023 Jan;22(1):4-6.
  • 18. Kuruvilla ME, Lee FE, Lee GB. Understanding Asthma Phenotypes, Endotypes, and Mechanisms of Disease. Clin Rev Allergy Immunol. 2019 Apr;56(2):219-233.
  • 19. Lee TA, Weaver FM, Weiss KB. Impact of pneumococcal vaccination on pneumonia rates in patients with COPD and asthma. J Gen Intern Med. 2007 Jan;22(1):62-7.
  • 20. Kostinov M, Chuchalin A, Chebykina A, et al. Clinical status and cytokine profiles in patients with asthma or chronic obstructive pulmonary disease vaccinated against influenza. PLoS One. 2025;20(2): e0313539.
  • 21. Chami-Peña S, Caballero-Vázquez A, Mebrive-Jiménez MJ, et al. Therapeutic Management in Patients with Chronic Obstructive Pulmonary Disease Who Are Overweight or Obese: A Systematic Review and Meta-Analysis. J Clin Med. 2025;14(4).
  • 22. Zhang Z-y, Li Y-h. Effects of different exercise regimens on prognosis of patients with chronic obstructive pulmonary disease: a systematic reviews and meta-analysis. Annals of Medicine.2024;56(1):2392022.
  • 23. Aslan Savaş Ş , Ç etin Y ılmaz S. The Impact of Nutritional Status on Disease Severity in COPD Patients. Dicle Med J 2025; 52 (4): 861-871.
  • 24. Rogliani P, Cavalli F, Ritondo BL, et al. Sex differences in adult asthma and COPD therapy: a systematic review. Respiratory Research. 2022;23(1):222.
  • 25. Lee C, Alexander E, Lee R, et al. Behavioral interventions for asthma self-management in South Asian populations: a systematic review. J Asthma. 2021;58(1):112-20.
  • 26. Fujii M, Nakano J, Tanaka Y, Tonosaki A. Effects of self-management interventions with behaviorchange support on long-term adherence in patients with chronic respiratory diseases: A systematic review. GHM Open. 2022 Aug 31;2(1):12-24.
  • 27. Barat E, Dubec E, Raymond J, et al. Management of asthma and COPD: Analysis of clinical profiles, post-hospitalization trajectories, and therapeutic interventions. Ann Pharm Fr. 2025.
  • 28. Kobayashi M, Leidner AJ, Gierke R, et al. Use of 21-Valent pneumococcal conjugate vaccine among U.S. adults: Recommendations of the Advisory Committee on Immunization Practices – United States, 2024. MMWR Morb Mortal Wkly Rep.2024;73(36):793-8.
  • 29. McLaughlin JM, Khan FL, Thoburn EA, et al. Rates of hospitalization for community-acquiredpneumonia among US adults: A systematic review. Vaccine. 2020;38(4):741-51.
  • 30. Health USDo, Human S. Active Bacterial Coresurveillance (ABCs): surveillance reports. 2024.

Obstrüktif Havayolu Hastalıkları Nedeniyle Hastaneye Yatırılan Hastalarda Farmakolojik ve Non-Farmakolojik Tedavilere Uyumun Rolü

Year 2026, Volume: 53 Issue: 1, 67 - 75, 10.03.2026
https://doi.org/10.5798/dicletip.1906428
https://izlik.org/JA94LA69ZB

Abstract

Amaç: Bu çalışmanın amacı, KOAH ve astım alevlenmesi nedeniyle hastaneye yatırılan hastalarda farmakolojik ve farmakolojik olmayan tedavilere uyum, hastanede yatış süresi ve ilişkili risk faktörlerini değerlendirmektir.
Yöntemler: Ocak–Mart 2023 tarihleri arasında göğüs hastalıkları kliniğine KOAH veya astım alevlenmesi tanısıyla yatırılan hastalarla kesitsel bir çalışma yapılmıştır. Toplum kökenli pnömoni tanılı ve bilinen KOAH veya astım tanısı olmayan hastalar kontrol grubu olarak dahil edilmiştir. Tedaviye uyumu değerlendirmek için Jeong ve ark. tarafından geliştirilen ve uyarlanmış geçerli bir anket kullanılmıştır. KOAH ve astım grupları kontrol grubu ile karşılaştırılmıştır. İstatistiksel analizlerde t-testi ve ki-kare testi kullanılmıştır.
Bulgular: Çalışmaya 30 KOAH, 12 astım ve 17 pnömoni hastası dahil edilmiştir. Katılımcıların ortalama yaşı 52,9±10,9 yıl olup %73’ü erkektir. KOAH hastaları astım hastalarına kıyasla anlamlı düzeyde daha yaşlı (p=0,04), daha çok erkek (p<0,001), daha fazla sigara öyküsüne sahip (p=0,020) ve daha düşük beden kitle indeksine (p=0,020) sahiptir. Hastanede yatış süresi ve alevlenme sayısı gruplar arasında benzerdi. Hem KOAH (%70) hem de astım (%66,7) hastalarında inhaler tedaviye uyum düşüktü. Aşı gibi farmakolojik olmayan tedavilere uyum da tüm gruplarda yetersizdi.
Sonuç: Demografik farklılıklara rağmen, KOAH ve astım hastaları benzer risk faktörlerine ve düşük tedavi uyumuna sahiptir. Klinik uygulamalarda farmakolojik ve farmakolojik olmayan tedaviye uyumu artırmaya yönelik stratejiler entegre edilmelidir. Bu sayede hastaneye yatış oranları azaltılabilir ve hasta sonuçları iyileştirilebilir.

References

  • 1. Global Initiative for A. Global Strategy for Asthma Management and Prevention 2024. 2024.
  • 2. Global Initiative for Chronic Obstructive Lung D. Global Strategy for the Diagnosis, Management, and Prevention of COPD: 2025 Report. 2025.
  • 3. Oh J , K im S , Y im Y, K im MS; G BD 2 023 G lobal Chronic Respiratory Disease and Covid Collaborators; Hay SI, I l S hin J , Y on D K. G lobal, regional, and national burden of chronic respiratory diseases and impact of the COVID-19 pandemic, 1990-2023: a Global Burden of Disease study. Nat Med. 2026 Jan;32(1):197-223.
  • 4. Singh D, Han MK, Bhatt SP. Is disease stability an attainable chronic obstructive pulmonary disease treatment goal? Am J Respir Crit Care Med. 2025;211(3):452-63.
  • 5. Çelik GE, Aydin Ö, Şen E, et al. Asthma–chronic obstructive pulmonary disease overlap: Results from a national multicenter study. Tuberk Toraks. 2024;72(1):25-36.
  • 6. Parasuaraman G, Ayyasamy L, Aune D, et al. The association between body mass index, abdominal fatness, and weight change and the risk of adult asthma: a systematic review and meta-analysis of cohort studies. Sci Rep. 2023;13(1):7745.
  • 7. Xiang, X., Huang, L., Fang, Y. et al. Physical activity and chronic obstructive pulmonary disease: a scoping review. BMC Pulm Med 22, 301 (2022).
  • 8. Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016 Dec 8;12(12):CD005305.
  • 9. Çolak Y., Afzal S., Marott JL., et al. Prognosis of COPD depends on severity of exacerbation history: A population-based analysis. Respir Med. 2019;155:141-7.
  • 10. Jeong H., Kim SH., Choi S., et al. Nonadherence to health promotion depending on chronic obstructive pulmonary disease severity. Heart Lung. 2022; 55:1-10.
  • 11. Mallya SG, Upadhyay A, Psoter KJ, et al. Association between difficulty affording medications and outcomes in chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2025.
  • 12. Koçak C, Polastri M, Pehlivan E. Creating homebased pulmonary rehabilitation programs for patients with asthma: insights from practice. J Yeungnam Med Sci. 2025;42:57.
  • 13. Hyvert S, Yailian AL, Haesebaert J, et al. Association between health literacy and medication adherence in chronic diseases: a recent systematic review. Int J Clin Pharm. 2023;45(1):38-51.
  • 14. Shao Y, Hu H, Liang Y, et al. Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. Patient Educ Couns. 2023 Sep;114:107829.
  • 15. Arismendi E, Ribo P, García A, et al. Asthma Control According to GINA 2023: Does Changing the Criteria Improve Asthma Control? J Clin Med. 2024 Nov 6;13(22):6646.
  • 16. George M, Bender B. New insights to improve treatment adherence in asthma and COPD. Patient Prefer Adherence. 2019 Jul 31;13:1325-1334. doi: 10.2147/PPA.S209532.
  • 17. Pandey AK, Verma AK, Singh A, et al. Management Strategies of COPD during the COVID-19 Pandemic. Tanaffos. 2023 Jan;22(1):4-6.
  • 18. Kuruvilla ME, Lee FE, Lee GB. Understanding Asthma Phenotypes, Endotypes, and Mechanisms of Disease. Clin Rev Allergy Immunol. 2019 Apr;56(2):219-233.
  • 19. Lee TA, Weaver FM, Weiss KB. Impact of pneumococcal vaccination on pneumonia rates in patients with COPD and asthma. J Gen Intern Med. 2007 Jan;22(1):62-7.
  • 20. Kostinov M, Chuchalin A, Chebykina A, et al. Clinical status and cytokine profiles in patients with asthma or chronic obstructive pulmonary disease vaccinated against influenza. PLoS One. 2025;20(2): e0313539.
  • 21. Chami-Peña S, Caballero-Vázquez A, Mebrive-Jiménez MJ, et al. Therapeutic Management in Patients with Chronic Obstructive Pulmonary Disease Who Are Overweight or Obese: A Systematic Review and Meta-Analysis. J Clin Med. 2025;14(4).
  • 22. Zhang Z-y, Li Y-h. Effects of different exercise regimens on prognosis of patients with chronic obstructive pulmonary disease: a systematic reviews and meta-analysis. Annals of Medicine.2024;56(1):2392022.
  • 23. Aslan Savaş Ş , Ç etin Y ılmaz S. The Impact of Nutritional Status on Disease Severity in COPD Patients. Dicle Med J 2025; 52 (4): 861-871.
  • 24. Rogliani P, Cavalli F, Ritondo BL, et al. Sex differences in adult asthma and COPD therapy: a systematic review. Respiratory Research. 2022;23(1):222.
  • 25. Lee C, Alexander E, Lee R, et al. Behavioral interventions for asthma self-management in South Asian populations: a systematic review. J Asthma. 2021;58(1):112-20.
  • 26. Fujii M, Nakano J, Tanaka Y, Tonosaki A. Effects of self-management interventions with behaviorchange support on long-term adherence in patients with chronic respiratory diseases: A systematic review. GHM Open. 2022 Aug 31;2(1):12-24.
  • 27. Barat E, Dubec E, Raymond J, et al. Management of asthma and COPD: Analysis of clinical profiles, post-hospitalization trajectories, and therapeutic interventions. Ann Pharm Fr. 2025.
  • 28. Kobayashi M, Leidner AJ, Gierke R, et al. Use of 21-Valent pneumococcal conjugate vaccine among U.S. adults: Recommendations of the Advisory Committee on Immunization Practices – United States, 2024. MMWR Morb Mortal Wkly Rep.2024;73(36):793-8.
  • 29. McLaughlin JM, Khan FL, Thoburn EA, et al. Rates of hospitalization for community-acquiredpneumonia among US adults: A systematic review. Vaccine. 2020;38(4):741-51.
  • 30. Health USDo, Human S. Active Bacterial Coresurveillance (ABCs): surveillance reports. 2024.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration, Medical Education, Health Services and Systems (Other)
Journal Section Research Article
Authors

Büşra Durak

Galip Koçyiğit

Hasan Can Alagöz

Canan Gündüz Gürkan

Submission Date November 13, 2025
Acceptance Date February 11, 2026
Publication Date March 10, 2026
DOI https://doi.org/10.5798/dicletip.1906428
IZ https://izlik.org/JA94LA69ZB
Published in Issue Year 2026 Volume: 53 Issue: 1

Cite

APA Durak, B., Koçyiğit, G., Alagöz, H. C., & Gündüz Gürkan, C. (2026). The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases. Dicle Medical Journal, 53(1), 67-75. https://doi.org/10.5798/dicletip.1906428
AMA 1.Durak B, Koçyiğit G, Alagöz HC, Gündüz Gürkan C. The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases. Dicle Medical Journal. 2026;53(1):67-75. doi:10.5798/dicletip.1906428
Chicago Durak, Büşra, Galip Koçyiğit, Hasan Can Alagöz, and Canan Gündüz Gürkan. 2026. “The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients With Obstructive Airway Diseases”. Dicle Medical Journal 53 (1): 67-75. https://doi.org/10.5798/dicletip.1906428.
EndNote Durak B, Koçyiğit G, Alagöz HC, Gündüz Gürkan C (March 1, 2026) The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases. Dicle Medical Journal 53 1 67–75.
IEEE [1]B. Durak, G. Koçyiğit, H. C. Alagöz, and C. Gündüz Gürkan, “The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases”, Dicle Medical Journal, vol. 53, no. 1, pp. 67–75, Mar. 2026, doi: 10.5798/dicletip.1906428.
ISNAD Durak, Büşra - Koçyiğit, Galip - Alagöz, Hasan Can - Gündüz Gürkan, Canan. “The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients With Obstructive Airway Diseases”. Dicle Medical Journal 53/1 (March 1, 2026): 67-75. https://doi.org/10.5798/dicletip.1906428.
JAMA 1.Durak B, Koçyiğit G, Alagöz HC, Gündüz Gürkan C. The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases. Dicle Medical Journal. 2026;53:67–75.
MLA Durak, Büşra, et al. “The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients With Obstructive Airway Diseases”. Dicle Medical Journal, vol. 53, no. 1, Mar. 2026, pp. 67-75, doi:10.5798/dicletip.1906428.
Vancouver 1.Büşra Durak, Galip Koçyiğit, Hasan Can Alagöz, Canan Gündüz Gürkan. The Role of Adherence to Pharmacological and Non-Pharmacological Treatments in Hospitalized Patients with Obstructive Airway Diseases. Dicle Medical Journal. 2026 Mar. 1;53(1):67-75. doi:10.5798/dicletip.1906428