The adherence and illness perception of patients diagnosed with asthma or chronic obstructive pulmonary disease treated with polytherapy using new generation Cyclohaler

Abstract

IntroductionThe factors influencing adherence of patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD) include the complexity of the therapy, fear of side effects of drugs, method of taking the drug, dosage regimen, polypharmacy, adverse events, knowledge about the essence of the disease and its complications, illness perception and priorities in life, training on the use of the inhaler, the duration of treatment, social support, and drug availability.AimTo assess the adherence of patients diagnosed with asthma and COPD treated with polytherapy with fluticasone propionate and formoterol fumarate using the Fantasmino inhaler in relation to primary diagnosis and illness perception as well as patients’ and doctors’ opinion about this form of therapy.Material and methodsA questionnaire survey covering adherence, illness perception and opinion about polytherapy using new generation Cyclohaler performed by pulmonologists, allergologists and general practitioners in 3,618 patients with asthma and 2,602 with COPD.ResultsOn visit 1, a lower adherence rate was observed in COPD than in the asthma group (72.0% vs. 61.5%; p < 0.01). During the observation, the adherence rate increased significantly in the COPD group, only (61.5% vs. 73.0%; p < 0.01). A negative correlation between total MMAS-8 and BIPQ scores was observed in both study groups (R = –0.15; p < 0.001 and R = –0.24; p < 0.001, respectively). During the observation, a percentage of patients who believed that the administration of the two drugs in a single inhaler considerably facilitates their use increased significantly in both study groups. In addition, an increased percentage of doctors believed that this therapeutic option facilitated education of patients and decreased the number of errors made by the patients.ConclusionsThe illness perception, younger age, disease duration and severity are predictors of adherence to treatment with fluticasone propionate and formoterol fumarate using the Fantasmino inhaler among patients with asthma and COPD. The positive opinion of patients and doctors about administration of fluticasone propionate and formoterol fumarate using the Fantasmino inhaler increased during observation.

Factors related to poor adherence in Latvian asthma patients

“…In contrast to our study, non-adherent behaviours were associated with more negative perceived consequences of illness in a British study conducted among 100 asthma patients [14]. Furthermore, in a large Polish survey of 3618 asthma patients, illness perception, younger age, disease duration and severity were predictors of adherence to treatment with fluticasone propionate and formoterol fumarate [26]. It has also been suggested that interventions focusing on illness perception helped to support chronic obstructive pulmonary disease patients in their disease management and to improve health-related quality of life [27].…”

“…According to that model adherence to treatment consists of several components that the patient can adopt to cope with their disease. Only a few studies have assessed the association between illness perception and treatment adherence in asthma patients [14,26]. In contrast to our study, non-adherent behaviours were associated with more negative perceived consequences of illness in a British study conducted among 100 asthma patients [14].…”

A cross-sectional study on the rate of non-adherence to anti-seizure medications and factors associated with non-adherence among patients with epilepsy

“…However, only a few addressed the WHO healthcare system dimension, particularly the access to pharmacy services. To address the patient-related dimension, we explored the patients' illness perception, which is thought to be a modifiable risk factor found to be significantly associated with medication adherence in other chronic diseases like diabetes, atrial fibrillation and chronic pulmonary diseases [22][23][24].…”

Factors related to good asthma control using different medical adherence scales in Latvian asthma patients: an observational study

“…Some of these factors are related to complexity of the therapy, fear of side effects of drugs, method of taking the drug, dosage regimen, adverse events, knowledge about the essence of the disease and its complications, illness perception and social support. 6 , 9 , 10 Especially, medical beliefs, cognitive and emotional perceptions have shown to be related to medical adherence. 11 , 12 Furthermore, individual asthma management might be improved by a better understanding of the types of beliefs or illness-related perceptions that are associated with low adherence to preventer medication.…”