Cystic fibrosis (CF) is a genetic and multisystemic disease that requires a high therapeutic demand for its control. The aim of this study was to assess therapeutic adherence (TA) to different treatments to study possible clinical consequences and clinical factors influencing adherence. This is an ambispective observational study of 57 patients aged over 18 years with a diagnosis of CF. The assessment of TA was calculated using the Medication Possession Ratio (MPR) index. These data were related to exacerbations and the rate of decline in FEV₁ percentage. Compliance was good for all CFTR modulators, azithromycin, aztreonam, and tobramycin in solution for inhalation. The patients with the best compliance were older; they had exacerbations and the greatest deterioration in lung function during this period. The three variables with the highest importance for the compliance of the generated Random Forest (RF) models were age, FEV₁%, and use of Ivacaftor/Tezacaftor. This is one of the few studies to assess adherence to CFTR modulators and symptomatic treatment longitudinally. CF patient therapy is expensive, and the assessment of variables with the highest importance for a high MPR, helped by new Machine learning tools, can contribute to defining new efficient TA strategies with higher benefits.

Background: Infection by SARS-CoV-2 has unquestionably had an impact on the health of patients with chronic respiratory airway diseases, such as COPD and asthma, but little information is available about its impact on patients with bronchiectasis. The objective of the present study was to analyze the effect of the SARS-CoV-2 pandemic on the state of health, characteristics, and clinical severity (including the number and severity of exacerbations) of patients with non-cystic fibrosis bronchiectasis. Methods: This study was multicenter, observational, and ambispective (with data collected before and during the SARS-CoV-2 pandemic), and included 150 patients diagnosed with non-cystic fibrosis bronchiectasis. Results: A significant drop was observed in the number and severity of the exacerbations (57% in all exacerbations and 50% in severe exacerbations) in the E-FACED and BSI multidimensional scores, in the pandemic, compared with the pre-pandemic period. There was also a drop in the percentage of sputum samples positive for pathogenic microorganisms in general (from 58% to 44.7%) and, more specifically, Pseudomonas aeruginosa (from 23.3% to 13.3%) and Haemophilus influenzae (from 21.3% to 14%). Conclusions: During the SARS-CoV-2 period, a significant reduction was observed in the exacerbations, severity, and isolations of pathogenic microorganisms in patients with bronchiectasis.

Background: CPAP during night rest is the first line treatment for OSAHS. However, several factors interfere in its adequate compliance and therefore, affect directly its effectiveness. Our study aim was to analyze most relevant causes of therapeutic noncompliance, as well as possible proposals to mitigate this problem. Methods: we have selected 175 individuals from a tertiary hospital pulmonology clinics whose compliance was lower than 60 minutes daily. We’ve analyzed the follow-up place, subjective treatment compliance, daily treatment hours, possible non-compliance reasons and what proposals improve adherence. We tried to contact these 175 patients by phone to complete a standardized questionnaire. Results: 133 patients were contacted. 9,77% do not develop any follow up. 62.4% admitted inadequate compliance, while the remaining (37.31%) denied it. 47 patients do not use CPAP, 39 use it between 1 and 5 hours, 43 between 6 and 8 hours and 4 more than 8 hours. Most common reasons for non-compliance were: interphase intolerance in 22.5% of patients and absence of clinical improvement in 9%. As a possible proposals, 51 patients suggested to make technical and interface improvements and 16 requested to receive more information about the disease and its treatment. 14 patients preferred to withdraw the CPAP therapy. Conclusion: subjective perception of patients own compliance is not always related to actual compliance. Most relevant measures to reduce inadequate compliance are: technical simplification and ergonomic interface improvements to increase the CPAP tolerance and offer all necessary information related to the disease and its treatment.