Highlights
- •We hypothesised that lower adherence was associated with higher FEV1 variability.
- •Objective adherence data from data-logging nebulisers were used.
- •We found a statistically significant association between lower adherence and higher FEV1 variability.
- •The clinical implications of this result need to be further investigated.
Abstract
At the same level of lung function, some patients with cystic fibrosis have large
variations in their FEV1 percent predicted (FEV1pp) values while others have stable
values. We hypothesised that lower adherence to nebuliser therapies was associated
with higher FEV1pp variability. We conducted a post hoc analysis of the ACtiF trial
data. Adherence was calculated using data from data-logging nebulisers, and FEV1pp
variability using the coefficient of variation equation. Amongst the 543 patients
included in the analysis, those poorly adherent (adherence < 50%) had a higher FEV1pp
variability than patients moderately (50 to < 80%) and highly adherent (≥ 80%), with
median values (IQR1–3) of 8.1% (4.9–13.7), 6.3% (3.9–9.8), and 6.3% (3.9–9.3) respectively
(p < 0.01). This result was confirmed by a multiple linear regression including adherence
as a continuous variable (p < 0.01). Further studies are needed to determine the implications of these differences
in FEV1pp variability on the prognosis of patients.
Keywords
Abbreviations:
BMI (body mass index), CF (cystic fibrosis), CFTR (cystic fibrosis transmembrane regulator), DAG (directed acyclic graph), FEV1 (forced expiratory volume in one second), UK (United Kingdom)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 14, 2023
Accepted:
March 6,
2023
Received in revised form:
February 14,
2023
Received:
November 30,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.
