Factors related to patients’ treatment adherence: evidence from a national COPD survey in China.

<bold>Background:</bold> Decreased adherence in COPD is associated with worse outcomes, with increased risk for exacerbations and long-term mortality. Method: We used data from the Enjoying Breathing Program until April 2023. All COPD patients were asked the question “whether to take medication as prescribed”, and patients answered the “yes” were those with good adherence, while others were bad adherence. <bold>Results:</bold> A total of 4156 COPD patients were included in the current analysis, with 3489 were good adherence and 667 were bad adherence. Patients live in urban are associated with good adherence than those live in rural (OR=1.76, 95%CI: 1.45-2.15). Compared with patients of high education level, COPD patients of low education were more likely to be bad adherence (OR=0.38, 95%CI: 0.21-0.66). COPD patients with symptoms were associated with good adherence (OR=4.67, 95%CI: 3.69, 5.89), and those with higher mMRC grade (OR=2.30, 95%CI: 2.07, 2.57) or higher CAT score (OR=1.13, 95%CI: 1.12, 1.15), which represented severer symptoms, were also associated with good adherence. Interestingly, compared with never smoking COPD patients, former smokers were associated with good adherence (OR=2.20, 95%CI: 1.75-2.80). Exposure to occupational dust (OR=0.53, 95%CI: 0.40, 0.72) and biofuel (OR=0.42, 95%CI: 0.35, 0.50) were associated with bad adherence. <bold>Conclusion:</bold> COPD patients live in urban, with higher education level, and worse symptoms were more likely to be good adherence. COPD patients of former smokers, those with occupational dust and biofuel exposure were associated with bad adherence. The results indicated that public awareness of risk factors of COPD exclude smoking is insufficient in China.