Factors that may affect a patient’s ability to use a device
Patients may unintentionally misuse or be nonadherent to COPD treatment, leading to less successful delivery of medication.2-4 Reasons for improper device use by patients may include the following:
1Physical and cognitive limitations
There is a high prevalence of comorbid conditions in COPD that have been shown to negatively affect inhaled therapy technique.5,6 A study of 995 patients recorded the following5:
2Lung function impairment
Low peak inspiratory flow rate (PIFR) has been shown to be predictive of greater rates of inhaler technique errors, even with attempts at proper adherence.6
3Patient satisfaction and adherence
An analysis of 1443 clinical patient surveys demonstrated that patients’ satisfaction with their COPD therapy device has a greater influence on compliance than the number of concomitant maintenance drugs, age, or severity of breathlessness.7
- The effect of a patient’s age on his or her ability to use a device correctly4
- The availability of a reliable caregiver to assist with setup or administration of treatment and/or cleaning of device8
Understanding your patient’s situation and needs
When you or your staff speak to patients with COPD and their caregivers, it’s important to gain a clear understanding of the patient’s situation and how the patient’s devices suit his or her needs.4,9 Download a quick guide that can help you have that conversation.
References: 1. Toy EL, Beaulieu NU, McHale JM, et al. Treatment of COPD: relationships between daily dosing frequency, adherence, resource use, and costs. Respir Med. 2011;105(3):435-441. 2. Fulvio B, Lavorini F, Blasi F, Baiardini I, Canonica GW. Switching treatments in COPD: implications for costs and treatment adherence. Int J Chron Obstruct Pulmon Dis. 2015;10:2601-2608. 3. Tashkin DP, Fabbri LM. Long-acting beta-agonists in the management of chronic obstructive pulmonary disease: current and future agents. Respir Res. 2010;11(149):1-14. 4. Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis. 2008;3(3):371-384. 5. Schnell K, Weiss CO, Lee T, et al. The prevalence of clinically relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999-2008. BMC Pulm Med. 2012;26:1-9. 6. Sulaiman I, Cushen B, Greene G, et al. Objective assessment of adherence to inhalers by COPD patients. Am J Respir Crit Care Med. 2016 Jul 13. [Epub ahead of print]. 7. Chrystyn H, Small M, Milligan G, Higgins V, Gil E, Estruch J. Impact of patients’ satisfaction with their inhalers on treatment compliance and health status in COPD. Respir Med. 2014;108(2):358-365. 8. Dhand R, Dolovich M, Chipps B, Myers TR, Restrepo R, Farrar JR. The role of nebulized therapy in the management of COPD: evidence and recommendations. COPD. 2012;9(1):58-72. 9. Virchow JC, Crompton GK, Dal Negro R, et al. Importance of inhaler devices in the management of airway disease. Respir Med. 2008;102(1):10-19.