Inhaler Adherence is Low Among COPD Patients

Only 36% of patients with chronic obstructive pulmonary disease (COPD) prescribed an inhaler had good adherence to therapy, according to a recent study.

The prospective observational study included 244 participants with COPD (mean age 71 years, 59% had mild to moderate cognitive impairment). Patients received a salmeterol/fluticasone inhaler with an electronic audio recording device (INCDA), which was used to quantify the frequency and proficiency of inhaler use. The interval between doses, time of use, and critical technique errors were combined to measure actual adherence based on intentional and unintentional nonadherence.
_____________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Is Standard COPD Therapy Effective in Alpha-1 Antitrypsin Deficiency?
Study Examines Efficacy of Add-On Antibiotic for COPD Exacerbations
_____________________________________________________________________________________________________________________________________________________________________

Overall, only 6% of participants had an actual adherence above 80%.

After grouping participants according to patterns of adherence, the researcher found that 34% of participants had low inhaler use and high error rates, 25% had high inhaler use and high error rates, and 36% had overall good adherence.

“Mean actual adherence was 22.6% of that expected if the doses were taken correctly and on time,” the researchers wrote.

Poor lung function and comorbidities were found to be predictive of poor technique. In addition, participants with poor adherence and frequent errors could be distinguished by age and cognition combined with poor lung function.

“These data may inform clinicians in understanding why a prescribed inhaler is not effective and to devise strategies to promote adherence in COPD,” the researchers concluded.

—Melissa Weiss

Reference:

Sulaiman I, Cushen B, Greene G, et al. Objective assessment of adherence to inhalers by patients with chronic obstructive pulmonary disease [published online May 15, 2017]. Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.201604-0733OC