{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:53:42Z","timestamp":1791179622261,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize adherence and adherence-related text features across three monthly telephone follow-ups among adults with cough variant asthma (CVA) newly initiating maintenance inhaled therapy and to evaluate their contemporaneous associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center, three-wave observational cohort classified adherence during the preceding month as high or low based on reported treatment implementation; records with insufficient information were unevaluable. A manually validated, rule-enhanced clinical natural language processing approach extracted seven non-mutually exclusive text features, including four prespecified patient-perceived barriers. Logistic generalized estimating equations (GEE) estimated population-averaged contemporaneous associations with high adherence. Complete-case GEE and wave-specific Firth models were conducted as sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 767 patients, adherence was evaluable for 732, 697, and 602 at Waves 1, 2, and 3, respectively; high adherence was documented in 94.4%, 73.9%, and 47.0% of evaluable records. Intentional discontinuation or dose reduction increased from 4.8% to 26.5%. The primary GEE included 2,031 observations. Lower odds of high adherence were associated with access or financial barriers (OR 0.28, 95% CI 0.16\u20130.49; P&amp;lt;0.001), illness- or treatment-related beliefs (OR 0.19, 95% CI 0.06\u20130.63; P\u00a0=\u00a00.007), and side-effect concerns or poor tolerability (OR 0.43, 95% CI 0.19\u20130.96; P\u00a0=\u00a00.040). Similar associations for access or financial barriers and illness- or treatment-related beliefs were observed in the complete-case and Wave 3 Firth analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High adherence was documented less frequently and patient-initiated treatment reduction more frequently at later waves. Access or financial barriers showed the most consistent contemporaneous association with lower odds of high adherence, whereas associations with illness- or treatment-related beliefs and side-effect concerns were less consistent across analyses. These record-based observational findings require prospective confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1966303","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:31:46Z","timestamp":1791178306000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inhaled treatment adherence patterns and related barriers across three monthly follow-up waves among patients with cough variant asthma: a clinical natural language processing study"],"prefix":"10.3389","volume":"17","author":[{"given":"Chun-juan","family":"Zhang","sequence":"first","affiliation":[{"name":"Affiliated Haiyan Hospital of Jiaxing University, Haiyan People\u2019s Hospital","place":["Jiaxing, Zhejiang, China"]},{"name":"School of Public Health, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiu-yue","family":"Shen","sequence":"additional","affiliation":[{"name":"Affiliated Haiyan Hospital of Jiaxing University, Haiyan People\u2019s Hospital","place":["Jiaxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu-juan","family":"Ma","sequence":"additional","affiliation":[{"name":"Affiliated Haiyan Hospital of Jiaxing University, Haiyan People\u2019s Hospital","place":["Jiaxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-feng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Affiliated Haiyan Hospital of Jiaxing University, Haiyan People\u2019s Hospital","place":["Jiaxing, Zhejiang, 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