Validation of the Test of Adherence to Inhalers (TAI) among Taiwanese Patients with Chronic Obstructive Pulmonary Disease

BACKGROUND It is important to have a psychometrically sound instrument assessing inhaler adherence of patients with chronic obstructive pulmonary disease (COPD). The present cross-cultural study aimed to validate the Chinese translation of the 10-item Test of Adherence to Inhalers (TAI) among 235 Taiwanese patients with COPD. MATERIAL AND METHODS The TAI was translated into Chinese and validated for Taiwanese patients with COPD. Eight experts evaluated the Chinese TAI, and their scores were used to examine content validity. Then, a total of 235 COPD patients (93.6% male, n=220; mean age=72.18 years, SD=10.19) were recruited using convenience sampling. A research assistant and a respiratory therapist conducted interviews to help patients complete the TAI and other related measures. Exploratory factor analysis, internal consistency, and relationship between TAI-defined adherence groups and the statement "Don't take medicine when there are no symptoms" were used to validate the Chinese TAI. RESULTS The content validity and internal consistency of the Chinese TAI were good (content validity index=0.975 for relevance, and 0.988 for clarity; alpha=0.82). The exploratory factor analysis suggested a single-factor structure. Moreover, the TAI-defined adherence groups had significantly different responses to the statement "Don't take medicine when there are no symptoms". CONCLUSIONS The Chinese TAI assessing inhaler adherence among Taiwanese patients with COPD effectively helps patients with COPD to identify their inhaler adherence. Researchers and healthcare providers can use the translated TAI to monitor adherence to inhaler for patients with COPD in Taiwan.