Up-to-date guidance towards improving medication adherence in patients with chronic obstructive pulmonary disease.

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-07-01 Epub Date: 2023-07-28 DOI:10.1080/17476348.2023.2239708
Meredith A Case, Michelle N Eakin
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Abstract

Introduction: Despite efficacious treatment for chronic obstructive pulmonary disease (COPD), medication adherence remains quite poor, with most estimates based on electronic monitoring devices ranging from 20-30%. This degree of nonadherence represents a significant missed opportunity to realize the benefits of treatment of this disease.

Areas covered: In this article, we review research on the prevalence of nonadherence among patients with COPD, the association of nonadherence with health outcomes, barriers to adherence in this patient population, and potential interventions.

Expert opinion: Integrating research into practice involves assessing patients' adherence, identifying modifiable barriers to adherence, open discussion of these barriers with patients, and tailored interventions to address them. These interventions may include treatment of previously unrecognized comorbid disease, providing educational or behavioral interventions, optimizing prescribing strategies, use of adherence aids, or addressing cost and other access barriers. Electronic inhaler monitors are promising interventions for both monitoring and improving adherence. However, remaining concerns about integration into patient care, data management, cost, acceptability, and ethical and privacy issues must be overcome prior to their implementation in clinical practice.

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改善慢性阻塞性肺病患者药物依从性的最新指南。
引言:尽管慢性阻塞性肺病(COPD)得到了有效的治疗,但药物依从性仍然很差,大多数基于电子监测设备的估计值在20-30%之间。这种程度的不依从性代表着严重错过了实现这种疾病治疗益处的机会。涵盖领域:在这篇文章中,我们回顾了关于COPD患者不依从性的患病率、不依从性与健康结果的关系、该患者群体中的依从性障碍以及潜在干预措施的研究。专家意见:将研究纳入实践包括评估患者的依从性,确定可改变的依从性障碍,与患者公开讨论这些障碍,并采取量身定制的干预措施来解决这些障碍。这些干预措施可能包括治疗以前未被识别的共病,提供教育或行为干预,优化处方策略,使用依从性辅助工具,或解决成本和其他获取障碍。电子吸入器监测仪是监测和改善依从性的有希望的干预措施。然而,在临床实践中实施之前,必须克服对整合到患者护理、数据管理、成本、可接受性以及道德和隐私问题的剩余担忧。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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