{
  "abstract": "Objective: 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.\n\nMethods: 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.\n\nResults: 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 0.16–0.49; P<0.001), illness- or treatment-related beliefs (OR 0.19, 95% CI 0.06–0.63; P = 0.007), and side-effect concerns or poor tolerability (OR 0.43, 95% CI 0.19–0.96; P = 0.040). Similar associations for access or financial barriers and illness- or treatment-related beliefs were observed in the complete-case and Wave 3 Firth analyses.\n\nConclusions: 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.",
  "abstract_shown": true,
  "affiliations": [
    "Affiliated Haiyan Hospital of Jiaxing University, Haiyan People’s Hospital",
    "School of Public Health, Zhejiang University School of Medicine"
  ],
  "article_type": "research support, non u.s. gov't",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Chun-juan Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qiu-yue Shen"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiu-juan Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Min-feng Zhou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6ej7cg1r1hg35.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1966303",
  "fulltext_url": "https://europepmc.org/articles/PMC13677862",
  "id": "6ej7cg1r1hg35",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1966303/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2714|Medication Adherence and Compliance"
    ]
  ],
  "openalex": "W7220396080",
  "pdf_url": "https://europepmc.org/articles/PMC13677862?pdf=render",
  "pmcid": "PMC13677862",
  "pmid": "42898473",
  "published": "2026-10-05",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/6ej7cg1r1hg35.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1966303",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1966303/full"
    },
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898473",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898473"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "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",
  "title_text": "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",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/6ej7cg1r1hg35",
  "venue": "Frontiers in Immunology",
  "versions": []
}