Determining factors associated with inhaled therapy adherence on asthma and COPD: A systematic review and meta-analysis of the global literature

Monteiro, C.; Maricoto, Tiago; Prazeres, Filipe; Simões, Pedro; Simões, José Augusto

doi:10.1016/j.rmed.2021.106724

Cited by 21 publications

(17 citation statements)

References 78 publications

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“…Adherence rates were estimated to range from 22% to 78% [ 24 ], and the adherence pattern varied between asthma and COPD—being more irregular among patients with asthma [ 25 ]. A recent meta-analysis has pointed to knowledge about the disease as a determining factor [ 26 ], while a Polish survey found patient discouragement, insufficient knowledge about the disease, and a lack of noticeable effects to be the main causes for stopping therapy (41.6%, 19.3% and 6.2% of all patients, respectively) [ 27 ]. According to our study, approximately one-half of the patients showed good treatment adherence, and the main reasons for poor adherence were a lack of knowledge about the disease or the device, in addition to the reasons identified in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study

Landete

Romo²,

Giacomini³

2022

Adv Ther

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Introduction Chronic obstructive pulmonary disease (COPD) and asthma are treatable but greatly underdiagnosed disorders. Telemedicine made it possible to continue diagnosis, follow-up visits and treatment modifications during the COVID-19 pandemic. The present study describes the management of patients with COPD and asthma, and their treatments during the pandemic from the pulmonologist’s perspective. Methods NEUMOBIAL was an ecological study with aggregated data. A total of 279 Spanish pulmonologists answered a 60-question survey about their last 10 patients, focused on the characterisation and changes in visits and treatments during the pandemic. Results Most pulmonologists (72.0%) considered that the pandemic negatively altered the diagnosis and follow-up of patients with asthma or COPD. Diagnostic tests were reduced during the pandemic, mainly because they were not recommended by pulmonologists (68.1% and 72.7% in the case of COPD and asthma tests, respectively). Moreover, 17.3% of the COPD and 19.1% of the asthma visits were remote visits. According to pulmonologists, low adherence to treatment was mainly due to a lack of patient knowledge about their disease (75.3% and 81.7% in COPD and asthma, respectively). Other factors that also influenced adherence were inadequate use of the inhaler (59.5% for COPD and 57.7% for asthma) and a lack of knowledge about the device (57.3% for COPD and 57.7% for asthma). Pulmonologists chose Zonda ® for COPD because of the ease of use of the device (73.1%) and the ability to check whether the entire dose was inhaled (69.5%). For asthma, Spiromax ® was chosen because of the ease of use of the device (85.7%) and the possibility of using a single device for maintenance and reliever treatment (82.4%). Conclusion According to pulmonologists, during the pandemic, treatments for COPD and asthma were mainly chosen on the basis of their ease of use; treatment adherence was good; and the number of remote visits increased. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02313-z.

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Section: Discussionmentioning

confidence: 99%

Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study

Landete

Romo²,

Giacomini³

2022

Adv Ther

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“…Cigarette smoking has been associated with poorer adherence to drug therapies for asthma in some 101 but not all studies. 102 An international cross-sectional study of over 4000 adults with asthma identified current smoking as a risk factor for >1 inhaler technique errors and worsening asthma outcomes among those who used a metered-dose inhaler but not among those who used a dry powder inhaler device. 103 Infection risk reduction for current smokers with asthma including smoking-related ACO involves annual influenza vaccination, 42 COVID-19 vaccination, and pneumococcal vaccination for patients >65 years.…”

Section: Targeting Non-adherence Poor Inhaler Technique and Infection...mentioning

confidence: 99%

Cigarette Smoking and Asthma

Thomson¹,

Polosa²,

Sin³

2022

The Journal of Allergy and Clinical Immunology: In Practice

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“…In the context of asthma, these have been explored in multiple research studies and several systematic reviews. 27,28 Specific determinants of interest are discussed later and summarized in ►Table 1.…”

Section: Causes Of Poor Treatment Adherencementioning

confidence: 99%

Improving Medication Adherence in Asthma

Kerr

Brennan

Hale

et al. 2022

Semin Respir Crit Care Med

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In little over a generation, the ingenuity of scientists and clinician researchers has developed inhaled medications and pathway-specific biological agents that control the inflammation and physiology of asthma. Unfortunately, whether it is because of cost or difficulty understanding why or how to use inhaled medications, patients often do not take these medications. The consequences of poor treatment adherence, loss of control and exacerbations, are the same as if the condition remained untreated. Furthermore, poor adherence is difficult to detect without direct measurement. Together this means that poor treatment adherence is easily overlooked and, instead of addressing the cause of poor adherence, additional medicines may be prescribed. In other words, poor treatment adherence is a risk for the patient and adds cost to healthcare systems. In this article, we discuss the rationale for and the delivery of successful interventions to improve medication adherence in asthma. We contextualize these interventions by describing the causes of poor treatment adherence and how adherence is assessed. Finally, future perspectives on the design of new interventions are described.

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Determining factors associated with inhaled therapy adherence on asthma and COPD: A systematic review and meta-analysis of the global literature

Cited by 21 publications

References 78 publications

Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study

Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study

Cigarette Smoking and Asthma

Improving Medication Adherence in Asthma

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