Format

Send to

Choose Destination
Multidiscip Respir Med. 2014 Nov 22;9(1):60. doi: 10.1186/2049-6958-9-60. eCollection 2014.

COPD: adherence to therapy.

Author information

1
Department of Respiratory Diseases, Monaldi Hospital, University Federico II, Naples, Italy.
2
Pneumology Thoracic Unit, Ospedale Maggiore della Carità, Novara, Italy.
3
Pulmonary and Endoscopic Thoracic Unit, AUSL, Ravenna, Italy.
4
Clinical Researcher, Respiratory Diseases, Institute of Clinical Physiology, G. Monasterio Tuscany Foundation/National Research Council, Pisa, Italy.
5
Department of Respiratory Diseases, Bellaria Hospital, Bologna, Italy.
6
Department of Pulmonary Diseases, Città della Salute e della Scienza Molinette, Torino, Italy.
7
Department of Pulmonary Diseases, S. Camillo - Forlanini Hospital, Rome, Italy.
8
Pharmacology Specialist, ASL, Bari, Italy.

Abstract

Adherence to medical therapies is a growing issue, so much so that the World Health Organization defined it as "a new pharmacological problem". The main factors affecting compliance are: frequency of administration, rapid onset of action, role of device. The most severe consequence of non-adherence is the increased risk of poor clinical outcome, associated with worsening of the quality of life and increase in health-care expenditure. It appears crucial to identify those COPD patients who are "poorly or not at all compliant with their treatment". In order to evaluate adherence to the medical therapy, several methods were proposed, the most effective of which turned out to be self-reports, i.e. simple, brief questionnaires (e.g. Morisky test). To increase the likelihood of quickly identifying non-compliant patients, it may be useful to administer a simple questionnaire to naïve subjects (for example, in the waiting room before an examination) including six specific items allowing to identify the patient's key characteristics. Depending on the answers, patients who do not comply with their pharmacological treatment may be classified as belonging to 6 phenotypes. For patients who are already under treatment it might be useful to administer another short questionnaire during follow up examination. Once the risk of non-compliance is identified, four possible types of measures can be taken: prescription-related, educational, behavioral and complex combined measures (combination of two or more actions). Therefore, while it is clear that adherence in COPD is a critical issue, it is also obvious that raising awareness on the disease and improving cooperation among specialists, general practitioners, health-care professionals, and patients is the starting point at which this evolution should immediately begin. Each medication is able to foster good compliance with the therapy, and consequently to maximize the efficacy, by virtue of its specific inhaler and its own active ingredient.

KEYWORDS:

Adherence; COPD; Inhaler; LABA; LAMA; Questionnaire

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center