{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:19:52Z","timestamp":1787822392580,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this paper is to examine inhaled formoterol concentrations in hair and assess the potential of hair analysis as a tool for measuring long\u2010term adherence, by validation with objective data from digital inhalers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Hair samples and digital inhaler data were collected from patients with COPD in 10 hospitals in the Netherlands as part of the TRICOLON trial. Hair samples were divided into three 1\u2009cm segments, each representing 1\u2009month of hair growth. Intra\u2010patient variability was investigated. Correlations between formoterol concentrations and digitally measured inhalations were assessed. Hair colour, dyeing, sex, body mass index (BMI) and smoking status were examined for their association and effect modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 96 patients who provided a hair sample, 49 had sufficient quality hair sample and digital data. Low intra\u2010patient variability was observed (intraclass correlation coefficient .94, 95% CI 0.87\u20130.97). Over a 3\u2010month period, a trend was observed in the correlation between the digitally recorded inhalations and hair formoterol concentration (correlation coefficient [\n                      <jats:italic>r<\/jats:italic>\n                      ]\u2009=\u2009.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.087). Regarding individual segments, a significant correlation was only found in the segment closest to the scalp (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.039). Higher formoterol concentrations were measured in dark hair and in those with a lower BMI. No effect modification by colour, dyeing, sex, BMI or smoking was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low intra\u2010patient variability of hair formoterol concentrations was observed in patients with stable adherence. However, inter\u2010patient variability and external factors may limit the correlation between formoterol concentrations in hair and adherence measured by a digital inhaler and thus the current utility of hair analysis as an adherence monitoring tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70590","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:37:15Z","timestamp":1779953835000},"page":"3235-3245","source":"Crossref","is-referenced-by-count":0,"title":["Hair analysis of formoterol as a novel tool to assess long\u2010term inhalation medication adherence: Data from the TRICOLON trial"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6656-1015","authenticated-orcid":false,"given":"Liz J. A.","family":"Cuperus","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine University of Groningen, University Medical Center Groningen, and Groningen Research Institute for Asthma and COPD  Groningen The Netherlands"},{"name":"Department of Pulmonary Medicine Franciscus Gasthuis and Vlietland  Rotterdam The Netherlands"},{"name":"Department of Pulmonary Medicine Erasmus Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Mireille A.","family":"Wessels","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University of Groningen, and University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huib A. M.","family":"Kerstjens","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine University of Groningen, University Medical Center Groningen, and Groningen Research Institute for Asthma and COPD  Groningen The Netherlands"},{"name":"Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, and University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daan J.","family":"Touw","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University of Groningen, and University Medical Center Groningen  Groningen The Netherlands"},{"name":"Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, and University Medical Center Groningen  Groningen The Netherlands"},{"name":"Department of Pharmaceutical Analysis Groningen Institute of Pharmacy, University of Groningen  Groningen The Netherlands"},{"name":"Medication Adherence Expertise Center of the northern Netherlands (MAECON)  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik W. 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A.","family":"Bischoff","sequence":"additional","affiliation":[{"name":"Department of General Practice Erasmus University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Job","family":"van der Palen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Medisch Spectrum Twente  Enschede The Netherlands"},{"name":"Section Cognition, Data and Education, Faculty of Behavioural, Management, and Social Sciences University of Twente  Enschede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnoud","family":"Aldenkamp","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Catharina Hospital  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"van Huisstede","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Northwest Clinics  Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folkert","family":"Brijker","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Spaarne Gasthuis  Haarlem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Dik","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Albert Schweitzer hospital  Dordrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidwien","family":"Graat\u2010Verboom","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Maxima Medical Center  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Goosens","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Gelre Ziekenhuizen  Zutphen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Th. 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A.","family":"Scholma\u2010Bronsema","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Wilhelmina Ziekenhuis Assen  Assen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2368-2262","authenticated-orcid":false,"given":"Job F. M.","family":"van Boven","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University of Groningen, and University Medical Center Groningen  Groningen The Netherlands"},{"name":"Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, and University Medical Center Groningen  Groningen The Netherlands"},{"name":"Medication Adherence Expertise Center of the northern Netherlands (MAECON)  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes C. C. 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