Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD

Abstract

Suboptimal adherence to pharmacological treatment of asthma and chronic obstructive pulmonary disease (COPD) has adverse effects on disease control and treatment costs. The reasons behind non-adherence revolve around patient knowledge/education, inhaler device convenience and satisfaction, age, adverse effects and medication costs. Age is of particular concern given the increasing prevalence of asthma in the young and increased rates of non-adherence in adolescents compared with children and adults. The correlation between adherence to inhaled pharmacological therapies for asthma and COPD and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Satisfaction with inhaler devices is also positively correlated with improved adherence and clinical outcomes, and reduced costs. Reductions in healthcare utilisation are consistently observed with good adherence; however, costs associated with general healthcare and lost productivity tend to be offset only in more adherent patients with severe disease, versus those with milder forms of asthma or COPD. Non-adherence is associated with higher healthcare utilisation and costs, and reductions in health-related quality of life, and remains problematic on an individual, societal and economic level. Further development of measures to improve adherence is needed to fully address these issues.

Metered dose inhaler-spacer use education effects on achieve asthma control in children

“…HCP should repeat this instructions at subsequent visits to confirm correct usage of inhaler device (29,30). Another critical step is the way of the education.…”

“…People with asthma and improper inhaler technique were shown to have poorer symptom control compared to those with good inhaler technique, with a subsequent increase in medical or emergency visits (8,11,20,25). Furthermore, as improved inhalation technique has been shown to improve adherence to asthma therapy (possibly due to the positive reinforcing effects of improved symptom relief concurrent with improved medication administration (29).…”

Impact of community pharmacists in COPD management: Inhalation technique and medication adherence

“…In some studies, around 60% of COPD patients had poor adherence to their inhalation therapy [14,15]. A recent review reported a wide variation in adherence rates for asthma and COPD patients ranging from 22% to 78% [16]. Regarding IT, evidence from Europe shows that up to 50% of patients fail to use their inhalers correctly [17].…”

Critical Steps: A Non-Interventional, Multicenter, Prospective, Observational Study on Critical Handling Errors with DPI Use, in Asthma and COPD Patients

“…Asthma and chronic obstructive pulmonary disease (COPD) are two of the leading causes of morbidity, mortality and economic burden worldwide [1]. Epidemiological data of Asthma in Greece are limited.…”

“…Chronic respiratory diseases represent 5% of total disease burden and 8.3% of chronic disease burden worldwide, accounting for more than 4 million deaths each year [1]. COPD is a leading cause of morbidity and mortality worldwide [4] and results in an economic and social burden which is substantial and increasing.…”