Medicus, Vol. 30 No. 2 Astma i KOPB, 2021.
Review article
Adherence of Patients to Inhalation Therapy – Has any Progress been Made?
Sanja Popović-Grle
Abstract
The World Health Organization (WHO) defines adherence as „the extent to which a person’s behavior – taking medication, etc., corresponds to a prescribed regime.” Adherence includes the patient’s consent to agreed health recommendations, which significantly differentiates adherence from compliance. Adherence tests with inhalers in asthma and COPD patients have exhibited upsetting results, where considerably less than half of patients only use the recommended inhaler for basic treatment of asthma or COPD on a regular basis throughout the year. On the other hand, some patients seek relief in short acting beta agonists (SABA) too often, which does not contribute to quality treatment, but instead to poorer control of the disease and increased asthma exacerbations. In addition, asthma patients may fully adhere to preventive treatment when symptoms arise, but become poorly adherent when they are stable and well. It is recommended that a person with asthma or COPD and their physician find the targeted treatment together. A motivational dialogue showing the physician’s positive emotions, empathy, active listening, stimulating questions and clear-cut answers, encouragement and celebration of small successes, as well as recapping conclusions at the end of the conversation, will significantly improve adherence. However, over time, knowledge and skill of the inhalation technique decreases, therefore training should be repeated at least once a year, preferably every three months, or at each medical check-up of asthma or COPD patients. Repeating and practicing adherence and inhalation techniques notably improves both variables. Medication monitoring improves adherence to instructions and regularity of their administration. Monitoring is recommended as a combination of self-assessment and pharmacist assessment by dosage usage.
Keywords
adherence; asthma; COPD; inhaler; , inhalation techniques; motivational dialogue; adherence measurement
Hrčak ID:
264158
URI
Publication date:
18.10.2021.
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