{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:02:18Z","timestamp":1790355738526,"version":"4.1.0"},"reference-count":29,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Nursing"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Gaps in knowledge, inhalation skills, and adherence continue to hinder effective chronic obstructive pulmonary disease (COPD) management.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The study was conducted to describe the status of COPD-related knowledge, practical skills for inhalation and breathing exercises, and treatment adherence among patients with COPD and to identify the relationships between these variables.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional study was conducted among 420 outpatients with COPD. Data were collected in 2 rounds, including interviews to assess patients\u2019 knowledge and treatment adherence and checklist-based observations of patients\u2019 practical skills. Multivariable logistic regression analysis was used to evaluate the associations between knowledge and practical skills and the status of treatment adherence.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 420 outpatients with COPD were included; 331 (78.8%) participants had inadequate COPD-related knowledge, 268 (63.8%) demonstrated adequate practical skills, and 155 (36.9%) achieved overall treatment adherence. In multivariable logistic regression, higher knowledge scores were associated with better treatment adherence (adjusted odds ratio [aOR] 1.20, 95% CI 1.06\u20101.31;\n P<\/jats:italic>\n =.001). Participants who correctly performed inhaler-use techniques were more likely to be adherent than those with incorrect technique (aOR 3.10, 95% CI 2.10\u20104.70;\n P<\/jats:italic>\n =.001). Likewise, adequate breathing-exercise skills were associated with higher adherence (aOR 1.70, 95% CI 1.08\u20102.71;\n P<\/jats:italic>\n =.02).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Higher COPD-related knowledge and better practical skills in inhaler use and breathing exercises were associated with better treatment adherence among outpatients with COPD. Because of the cross-sectional design, these findings indicate associations rather than causal relationships. These observed associations may help inform future intervention studies evaluating patient education and skill-based training, although their effectiveness should be confirmed in longitudinal or interventional studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/83132","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:13:10Z","timestamp":1790352790000},"page":"e83132-e83132","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Treatment Adherence in Outpatients With Chronic Obstructive Pulmonary Disease: Cross-Sectional Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8457-8285","authenticated-orcid":false,"given":"Hien","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-2670","authenticated-orcid":false,"given":"Trieu","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2075-0389","authenticated-orcid":false,"given":"Hoai","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3634-8698","authenticated-orcid":false,"given":"Giang","family":"Luong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1655-4441","authenticated-orcid":false,"given":"Doanh","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6849-4700","authenticated-orcid":false,"given":"Thong","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"R1","unstructured":"Global strategy for prevention, diagnosis and management of COPD: 2024 report. 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