{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:04:52Z","timestamp":1789538692378,"version":"build-2803163510"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Improving adherence to inhaled medication is crucial for optimal treatment outcomes and effective disease management in chronic obstructive pulmonary disease (COPD) patients. This study aimed to investigate adherence to inhaled medication and its association with medication beliefs among COPD patients in Xi\u2019an, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted with 448 COPD inpatients recruited from two large tertiary hospitals in Xi\u2019an, China, between May 1, 2024, and January 31, 2026. The Beliefs about Medicines Questionnaire Specific (BMQ-Specific) was used to assess inpatients\u2019 beliefs about inhalers, and the Medication Adherence Report Scale (MARS-5) was employed to evaluate adherence to inhaled medication. Logistic regression analyses were performed to examine the associations between independent variables and medication non-adherence. Three sensitivity analyses were conducted in this study to confirm the model\u2019s reliability. Model discrimination was assessed using ROC analysis, and internal validation was performed using 1,000 bootstrap resamples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 266 (59.4%) inpatients were non-adherent to inhaled medication. Overall, 243 (54.2%) inpatients expressed strong necessity beliefs about inhaled medication, while 203 (45.3%) held strong concern beliefs. Multivariable logistic regression analysis revealed that inpatient who expressed weaker necessity beliefs about inhaled medication had 4.79-fold odds (95% CI\u202f=\u202f3.044\u20137.520;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001) of non-adherence compared with those who expressed stronger necessity beliefs. Inpatient who received dual therapy with LABA-ICS had 2.00-fold odds (95% CI\u202f=\u202f1.027\u20133.900;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.042) of non-adherence compared with those who received triple therapy with LAMA-LABA-ICS, whereas inpatient who was unemployed or retired was more likely to be adherent to inhaled medication (adjusted OR 0.534 [0.320, 0.889];\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.016) than those in physical labor occupations. The association between necessity beliefs and medication adherence remained statistically significant upon validation in three sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The relatively low adherence to inhaled medication among inpatients with COPD in Northwestern China highlights the urgent need for effective strategies to improve adherence. These findings suggest a potential clinical implication wherein pharmacists and nurses could play a supportive role in promoting medication adherence among patients with COPD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1934660","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:32:07Z","timestamp":1789536727000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between medication beliefs and medication adherence among inpatients with chronic obstructive pulmonary disease: a cross-sectional survey"],"prefix":"10.3389","volume":"14","author":[{"given":"Haiyan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Xi\u2019an People\u2019s Hospital (Xi\u2019an Fourth Hospital), Affiliated People\u2019s Hospital of Northwest University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nannan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital of Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junfei","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital of Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoni","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Science and Education, Xi\u2019an Mental Health Center","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1016\/S0140-6736(25)01917-8","article-title":"Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the global burden of disease study 2023","volume":"406","year":"2025","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1016\/S0140-6736(18)30841-9","article-title":"Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China pulmonary health [CPH] study): a national cross-sectional study","volume":"391","author":"Wang","year":"2018","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/S2213-2600(21)00511-7","article-title":"Global, regional, and national prevalence 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