To know more about our studies, visit our SPUR Research website. 


The aim of this study was to explore the validity of the SPUR™ tool as a holistic Patient-Reported Outcome Measure of medication adherence in Chronic Obstructive Pulmonary Disease (COPD). The study has been published in Patient Preference and Adherence. 

The 2 key outputs to keep in mind

  • The predictive validity of SPUR™ to measure adherence of chronic patients living with COPD is confirmed.
  • SPUR™ score is correlated with CAT (COPD Assessment Test) and can identify worsening symptom severity.


100 adult patients suffering from COPD from a large London NHS Trust with at least 1 inhaler prescribed for a minimum of 6 months prior to the study were surveyed.

Patients provided demographic and health-related information and filled out the following questionnaires:

  • SPUR™
  • Validated PROMs measuring adherence
    o The Inhaler Adherence Scale (IAS)
    o The Medication Possession Ratio (MPR)
  • Symptom severity assessment tool:
    o The COPD Assessment Test (CAT)

Spearman’s rank correlation coefficient was calculated to examine correlations between the various PROMs and SPUR.
A Chi-square analysis was conducted to explore the relationship between the CAT and SPUR.


SPUR™ score is correlated with established Patient-Reported Outcomes (PROMs) in this study. Its predictive validity to measure medication adherence in COPD is confirmed.

SPUR™ is also significantly associated to COPD symptom severity. This finding could be applied in clinical practice to prospectively address patient outcomes linked to poor medication adherence.

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