Objective Assessment of Adherence to Inhalers by Patients with Chronic Obstructive Pulmonary Disease

Sulaiman, Imran; Cushen, Breda; Greene, Garrett; Seheult, Jansen N.; Seow, Dexter; Rawat, Fiona; MacHale, Elaine; Mokoka, Matshediso; Moran, Catherine; Bhreathnach, Aoife Sartini; MacHale, Philippa; Tappuni, Shahed; Deering, Brenda; Jackson, Mandy; McCarthy, H; Mellon, Lisa; Doyle, Frank; Boland, Fiona; Reilly, Richard B.; Costello, Richard W.

doi:10.1164/rccm.201604-0733oc

Cited by 193 publications

(173 citation statements)

References 44 publications

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“…In another study of 265 patients with COPD, adherence was measured using a tool incorporating sophisticated electronic devices to mark time and correctness of the technique; adherence over the study was 22.9% of what would be expected if all the doses had been taken correctly and on time, but more important adherence was negatively inluenced by impairment in cognitive function [82].…”

Section: Clinical Consequences Of An Afected Cognition; Measure Methodsmentioning

confidence: 99%

Neurocognitive Impairment as Systemic Effects of COPD

Oancea¹,

Tudorache²,

Tudorache³

2018

COPD - An Update in Pathogenesis and Clinical Management

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Mild cognitive impairment (MCI), also known as incipient dementia, is characterized by the decline of cognitive function greater than expected for a certain age and educational level of the individual but not severe enough to interfere with their daily activities. However, this mild cognitive impairment afects several areas: visuospatial, memory, atention and luency and it is a signiicant concern because it decreases the quality of life and treatment adherence of these patients. On the other hand, evidence suggests that individuals with Chronic obstructive pulmonary disease (COPD) also present an important risk of falls: 46% of these patients experience a fall/year, sometimes with fatal consequences. Standard clinical balance measures can predict the risk of falls in this population. Moreover, increased inlammatory biomarkers are associated with the decrease of cognitive functions and a higher risk of falls in this population. Patients with COPD have a higher balance and cognitive impairment than their healthy peers Therefore, it is important to identify, assess and understand the relevance of these comorbidities in order to characterize the full clinical spectrum of COPD and adjust prevention strategies, given the devastating consequences of these problems.

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Section: Clinical Consequences Of An Afected Cognition; Measure Methodsmentioning

confidence: 99%

Neurocognitive Impairment as Systemic Effects of COPD

Oancea¹,

Tudorache²,

Tudorache³

2018

COPD - An Update in Pathogenesis and Clinical Management

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“…This recommendation acknowledges the evidence suggesting that the inhalation technique of the COPD patient may not be always appropriate, nor the compliance with treatment be optimal [29]. According to recent data on inhaler technique errors, it seems that only 6% of the patients have an optimal skill and adherence with inhalers [30]. Thus, it is necessary that clinicians recognize the different devices and techniques, and suggest the most appropriate for each individual patient [31].…”

Section: Disease Managementmentioning

confidence: 84%

GOLD 2017 recommendations for COPD patients: toward a more personalized approach

2017

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The Global Initiative for Chronic Obstructive Lung Disease (GOLD), an international committee of experts, has recently published its updated report on diagnosis and management of Chronic Obstructive Pulmonary Disease (COPD). Compared to the previous version, this documents has been an extensively revised: the definition has been simplified, highlighting the importance of respiratory symptoms, and disease development is further discussed, including new insights on lung development. Spirometry is still required for the diagnosis, and it is described as fundamental tool for evaluating prognosis, disease progression, and non-pharmacologic treatment. However, differently from the previous version, spirometry is no longer included in the ABCD tool (ie, a practical tool proposed to assess COPD symptom burden and guide pharmacologic treatment), which is now centered exclusively on respiratory symptoms and history of exacerbation. Subsequently, pharmacologic treatment has been shifted towards a more personalized approach, reflecting the ongoing process toward a comprehensive, patient-tailored management.

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“…For example, a recent study shows that cognitive functioning as assessed with the Montreal Cognitive Assessment is able to distinguish COPD patients with poor adherence to inhaler therapy from those with frequent errors in inhaler use technique. 43 Therefore, a comprehensive assessment of cognitive functioning and accurately distinguishing cognitive impairment among multiple cognitive domains might become more important, as more specific therapy interventions can be developed by taking into account the possible consequences of domain-specific cognitive impairment. Moreover, in patients with brain injuries, Alzheimer disease, and multiple sclerosis, cognitive training strategies, which aim to improve cognitive functioning and consequently reduce functional and psychological problems, have already been applied.…”

Section: Clinical Consequencesmentioning

confidence: 99%