International Journal of COPD (Dec 2023)
Inhaler Adherence in COPD: A Crucial Step Towards the Correct Treatment
Abstract
Miguel Turégano-Yedro,1 Eva Trillo-Calvo,2 Fernando Navarro i Ros,3,4 José David Maya-Viejo,5 Cruz González Villaescusa,6,7 Jose Maria Echave Sustaeta,8 Esperanza Doña,9 Bernardino Alcázar Navarrete10,11 1Centro de Salud Casar de Cáceres, Casar de Cáceres, Cáceres, Spain; 2Centro de Salud Campo de Belchite, Belchite, Zaragoza, Spain; 3Centro de Salud Ingeniero J Benlloch, Valencia, Spain; 4Red Investigadores SEMERGEN, Madrid, Spain; 5Unidad de Gestión Clínica de Camas, Distrito Sanitario Aljarafe-Sevilla Norte, Camas, Sevilla, Spain; 6Servicio de Neumología, Hospital Clínico Universitario de Valencia, Valencia, Spain; 7Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain; 8Servicio de Neumología, Hospital Universitario Quironsalud, Universidad Europea de Madrid, Madrid, Spain; 9Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Regional Universitario de Málaga, Málaga, Spain; 10Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain; 11Instituto de Investigación Biosanitaria, Ibs- Granada, Granada, SpainCorrespondence: Miguel Turégano-Yedro, Centro de Salud Casar de Cáceres, Casar de Cáceres, C/ Barrionuevo Bajo, 49, Casar de Cáceres, Cáceres, 10190, Spain, Tel +34-927291531, Email [email protected]: COPD is a typical example of chronic disease. As such, treatment adherence tends to be as low as between 30% and 50%, with specific issues in COPD due to the use of inhaled therapies. Decreased adherence in COPD is associated with worse outcomes, with increased risk for exacerbations and long-term mortality. Factors that impact adherence are multiple, some related to patient, some related to clinicians and finally some related to healthcare system. Among clinician factors, prescription of simplified treatment regimens delivered by an inhaler adapted to the patient’s characteristics is crucial. Although it has been observed a huge improvement in the design and usability of inhaler devices for COPD in the last two centuries, there is still a clear gap in this field. Smart inhalers as well as simplified treatment regimens could improve adherence and therefore improve long-term outcomes in COPD.Plain Language Summary: Treatment adherence in COPD is crucial as in many other chronic diseases, with specific issues due to inhaled route, and many factors involved. Low adherence in COPD has been linked to an increased risk of exacerbations and future mortality. Many interventions have been developed to improve treatment adherence in COPD. This review summarizes the current knowledge and future prospects for this important aspect of COPD treatment.Keywords: COPD, inhaled therapies, adherence, persistence, posology
