Adherence,Satisfaction,Inhaler Technique,and Inspiratory Performance in Patients With Chronic Obstructive Pulmonary Disease:A Cross-Sectional Study

Abstract Background: Adherence, satisfaction, medication accuracy, and the ability to self-administer inhaled medications among patients with Chronic Obstructive Pulmonary Disease(COPD) directly impact the effectiveness of drug therapy.Therefore, this study aims to examine the current levels of adherence, satisfaction, medication accuracy, the ability to self-administer inhaled medications , and symptom control among patients with COPD, and to analyze the correlations among these factors. Methods: A cross-sectional survey was conducted at a single tertiary hospital in Xinjiang, China(July 2025-April 2026). Symptom burden (COPD Assessment Test [CAT]), adherence (Test of Adherence to Inhalers [TAI]), and satisfaction (Feeling of Satisfaction with Inhaler-10 [FSI-10]) were assessed in 141 patients with COPD. Inhaler technique was objectively evaluated in 65 patients using a locally developed assessment form;peak inspiratory flow (PIF) and effective inhalation time (EIT) were measured in 44 patients using a respiratory rehabilitation trainer. Overlap between the objective-assessment subgroups and the questionnaire cohort was incomplete. Results: Patients reported moderate disease burden (CAT: 17.09 ± 5.97 ) and low adherence (TAI: 44.21 ± 7.24), yephigh satisfaction (FSI-10: 46.59 ± 3.50). Satisfaction correlated positively with adherence (r = 0.423, P < 0.001). Only 13 / 65(20.00%) demonstrated proficient inhaler technique. Among 44 tested patients, 30 (68.18%) had subthreshold minimum effective PIF and 40 (90.91%) had insufficient effective inhalation time. Conclusion: Despite high satisfaction, patients with COPD showed low adherence and poor objective inhaler proficiency and inspiratory performance, indicating a gap between perceived and actual inhaler use. These exploratory findings are hypothesis-generating and warrant confirmation in larger, prospective studies. Trial Registration: Chinese Clinical Trial Registry; NO.: ChiCTR2600116969;Registration date: 2026-01-18 URL: http://www.chictr.org.cn