Usability of the test of adherence to inhalers toolkit to patients with COPD in Kyrgyzstan

Abstract COPD remains a major health burden worldwide, with adherence to inhaled therapy being a key determinant of treatment success. The Test of Adherence to Inhalers (TAI) is a validated tool for assessing adherence, but does not provide tailored interventions. The TAI Toolkit was developed to address this gap by offering individualized adherence-enhancing strategies. We aimed to assess the usability of the TAI Toolkit among healthcare professionals in Kyrgyzstan. This observational study was conducted in primary and tertiary care settings at the National Centre of Cardiology and Internal Medicine in Bishkek, Kyrgyzstan. The TAI Toolkit was translated and adapted for the local context. Nine physicians and three residents applied the TAI Toolkit in routine practice with 100 COPD patients. Healthcare professionals received training and later assessed the TAI Toolkit’s usability using the System Usability Scale (SUS). Primary outcomes included usability and feasibility, while secondary outcomes focused on adherence-enhancing interventions provided and patient and physician satisfaction. The mean SUS score was 74.6 (SD = 5.7), indicating good usability. Overall, 91.7% of physicians were satisfied with the Toolkit. The most frequently provided interventions were medication plans (91.7%), reminders and/or counseling (83.3%), and education and/or counseling (83.3%). Patients and physicians reported high satisfaction, with mean ratings of 8.8 (SD = 1.3) and 8.6 (SD = 1.9), respectively. The TAI Toolkit demonstrated good feasibility and usability among Kyrgyz healthcare professionals. Both patients and physicians found it beneficial for improving inhaler adherence management in COPD. Future research should explore its long-term clinical outcomes.