Patient adherence in COPD

Abstract

Patient adherence to treatment in chronic obstructive pulmonary disease (COPD) is essential to optimise disease management. As with other chronic diseases, poor adherence is common and results in increased rates of morbidity, healthcare expenditures, hospitalisations and possibly mortality, as well as unnecessary escalation of therapy and reduced quality of life. Examples include overuse, underuse, and alteration of schedule and doses of medication, continued smoking and lack of exercise. Adherence is affected by patients’ perception of their disease, type of treatment or medication, the quality of patient provider communication and the social environment. Patients are more likely to adhere to treatment when they believe it will improve disease management or control, or anticipate serious consequences related to non-adherence. Providers play a critical role in helping patients understand the nature of the disease, potential benefits of treatment, addressing concerns regarding potential adverse effects and events, and encouraging patients to develop self-management skills. For clinicians, it is important to explore patients’ beliefs and concerns about the safety and benefits of the treatment, as many patients harbour unspoken fears. Complex regimens and polytherapy also contribute to suboptimal adherence. This review addresses adherence related issues in COPD, assesses current efforts to improve adherence and highlights opportunities to improve adherence for both providers and patients.

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

“…Some authors argue for poor IT to be a form of poor adherence [13], whereas others see that poor adherence can be triggered by poor IT, as the latter can result in patient's dissatisfaction with the treatment [3]. This can lead to medication wastage due to prescribing higher doses or even additional medications thus increasing the financial burden of the disease on healthcare systems [7,10].…”

Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

“…Physicians play a significant role in decreasing the HBV burden among Asian Americans by improving the identification and care of persons with chronic HBV, 11 promoting patient knowledge about HBV and liver cancer, and advising patients to get screened or follow treatment recommendations. [12][13][14][15][16] Effective patient-physician communication can improve patients' use of health care services and compliance with health care directives. [17][18][19] Problems with communication may negatively affect patients' perceptions of illness, screening, and treatment.…”

The INCATM (Inhaler Compliance AssessmentTM): A comparison with established measures of adherence

“…Global prevalence of COPD is projected to increase; such that by 2020, COPD is predicted to be the third leading cause of death, and fifth leading cause of disability worldwide (Lopez, Mathers, Ezzati, Jamison, & Murray, 2006). The chronic, progressive and debilitating nature of COPD, alongside its high prevalence, confers significant burden on the healthcare system (Bourbeau & Bartlett, 2008).…”