Melike Yüksel Yavuz1 , Muzaffer Onur Turan1 , Sıtar Güneş1 , Çağrı Cenk Öztürksoy1 , Melih Kaan Sözmen2 , Ceyda Mahleç1 , Bünyamin Sertoğullarından1 2Department of Public Health, İzmir Katip Çelebi University School of Medicine, İzmir, Türkiye
Abstract
BACKGROUND AND AIM: This study aimed to evaluate the validity, reliability, and diagnostic accuracy of the Turkish version of the Test of Adherence to Inhalers (TAI), a widely used tool for assessing inhaler adherence, in patients with asthma and COPD.
METHODS: This cross-sectional study included 100 patients with asthma (n = 50) or COPD (n = 50) followed in outpatient clinics between February and May 2024. Adherence was assessed using the TAI-10 and TAI-12 questionnaires and the Morisky Medication Adherence Scale. Internal consistency was evaluated using Cronbach’s alpha coefficients. Construct validity was examined by Spearman correlation analysis, and diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis.
RESULTS: The mean age was significantly higher in the COPD group than in the asthma group (70.9 ± 8.3 vs. 48.0 ± 17.3 years, p < 0.001). Groups differed significantly in gender distribution, comorbidities, smoking status, symptom burden, and exacerbation history (all p < 0.05). TAI and Morisky scores did not differ significantly between asthma and COPD patients. The Turkish TAI demonstrated good internal consistency (Cronbach’s α = 0.836 for TAI-10 and 0.826 for TAI-12) and strong correlations with Morisky scores (r = 0.917 and r = 0.902; p < 0.001). Both versions showed high diagnostic accuracy for identifying non-adherence (AUC = 0.892 and 0.876), with optimal cut-off values of ≤45 and ≤47, respectively.
CONCLUSIONS: The Turkish versions of TAI-10 and TAI-12 are valid, reliable, and accurate tools for assessing inhaler adherence in patients with asthma and COPD.
