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COPD: Delving into Inhaler Adherence

To achieve optimal outcomes, it is essential that patients with chronic obstructive pulmonary disease (COPD) adhere to the long-term use of pharmacotherapies. Patients who follow their treatment plan are less likely to experience exacerbation, hospitalization and preventable death. Often, they also have fewer medical costs than those who are not adherent.  

According to a study, poor inhaler adherence increased the “risk of hospitalization by 58% and death by 40%.” Although most patients are aware that COPD is a progressive condition, overall medication adherence is significantly low. To reverse this trend, it is critical that healthcare teams collaborate to “ensure that patients with COPD use medications properly, consistently, and persistently.”

122017image002Inhalers are critical to successful COPD management. In recent years, researchers have discovered two approaches that can aid healthcare providers in assessing COPD patients’ medication use. The Morisky-Green test consists of four questions that clinicians should ask patients regarding their attitude toward their medication. Similarly, the Batalla test consists of two questions that clinicians can ask to assess a patient’s knowledge and understanding of their condition.

Improving Adherence

Patients who have received education regarding their COPD have confidence in their medication and hold realistic expectations about their treatment have a higher likelihood of faithful use. However, patients who doubt the effectiveness of both their medications and clinicians, and who smoke or have comorbid depressed, have a higher probability of nonadherence.

Patients’ attitudes towards their medications are a key determinant of how often and consistent the use. This supports the need for pharmacists to encourage adherence by explaining how a patient’s “medications work, when to use as-needed doses,” and what to expect.  

Getting the Medication and Inhaler Right

Pharmacists can also help to improve adherence through medication selection. Patients may be adherent to one inhaler, yet fail to use another for various reasons such as preferring a once-daily dose administration.

By considering each patient’s needs and preferences, including the patient’s medication use history and the individual inhaler’s characteristics, “pharmacists can help patients with COPD find the inhalers to which they are most likely to adhere.”

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