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Adherence to Therapy in Chronic Obstructive Pulmonary Disease: A Systematic Review

  • Natalia Świątoniowska
  • Mariusz Chabowski
  • Jacek Polański
  • Grzegorz Mazur
  • Beata Jankowska-PolańskaEmail author
Chapter
  • 89 Downloads
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1271)

Abstract

Adherence to therapy plays a key role in treatment optimization and clinical outcome in patients with chronic obstructive pulmonary disease (COPD). The adherence to inhaled medications is poor, ranging from 20% to 60%. In this study we searched Medline and PubMed literature regarding factors that could have an impact on therapy adherence in COPD patients, using the key words “COPD” or “chronic obstructive pulmonary disease” and “adherence”. The search was limited to the English language article published between January 2013 and December 2019. Review papers, study protocols, and meta-analyses were excluded. The final material included 25 articles. The evaluation was performed using the Cochrane Review Manager guidelines. The 25 articles represented 29 countries from 5 continents. We assessed adherence to therapy and the impact of selected factors on the adherence in 27,660 COPD patients (60.9% of whom were male, mean age 64 years). The factors affecting adherence were broken down into three categories: sociodemographic, clinical, and psychological. There were two standardized instruments used in the analyzed studies: Test of Adherence to Inhalers (TAI) and self-reported Morisky Medication Adherence Scale (MMAS-8). We found that 46.3% of patients had a moderately good level of adherence to inhaled therapy (TAI range around 50 points), while 41.6% of patients had a high level of adherence to oral therapy. The nature of non-adherence was in most cases inadvertent rather than an erratic or deliberate demeanor (48.5% vs. 38.9% vs. 42.4%, respectively). We conclude that standardized instruments enable the prediction of adherence to therapy and should be used in clinical practice. The assessment of adherence is essential for undertaking interventions to counteract plausible non-adherence. Collaboration between an educator and a psychologist is required to evaluate the patient’s motivation and to ensure his comprehension of treatment prescribed.

Keywords

Adherence to therapy Clinical practice COPD Treatment optimization 

Notes

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Ethical Approval

This is a literature review article that does not contain any current studies or experiments with human participants or animals performed by any of the authors. The writing of this article was accepted by the scientific Review Board of Wroclaw Medical University in Poland.

Informed Consent

There are no individual participants included in this review article. Therefore, there was no requirement to obtain individual informed consent.

References

  1. Ágh T, Inotai A, Mészáros Á (2011) Factors associated with medication adherence in patients with chronic obstructive pulmonary disease. Respiration 82(4):328–334PubMedCrossRefGoogle Scholar
  2. Barja-Martínez E, Casas-González S, Simón-López AF, Mancheño-Ovejero C, Padial-de la Cruz MLG (2019) Adherence to inhaled therapy in the outpatient setting. Enferm Clin 29(1):34–38. (Article in Spanish)PubMedCrossRefGoogle Scholar
  3. Bourbeau J, Bartlett SJ (2008) Patient adherence in COPD. Thorax 63(9):831–838PubMedPubMedCentralCrossRefGoogle Scholar
  4. Broadbent E, Garrett J, Jepsen N, Li Ogilvie V, Ahn HS, Robinson H, Peri K, Kerse N, Rouse P, Pillai A, MacDonald B (2018) Using robots at home to support patients with chronic obstructive pulmonary disease: pilot randomized controlled trial. J Med Internet Res 20(2):e45PubMedPubMedCentralCrossRefGoogle Scholar
  5. Campbell DJ, Ronksley PE, Manns BJ, Tonelli M, Sanmartin C, Weaver RG, Hennessy D, King-Shier K, Campbell T, Hemmelgarn BR, Interdisciplinary Chronic Disease Collaboration (2014) The association of income with health behavior change and disease monitoring among patients with chronic disease. PLoS One 9(4):e94007PubMedPubMedCentralCrossRefGoogle Scholar
  6. Canonica GW, Baena-Cagnani CE, Blaiss MS, Dahl R, Kaliner MA, Valovirta EJ, GAPP Survey Working Group (2007) Unmet needs in asthma: Global Asthma Physician and Patient (GAPP) Survey: global adult findings. Allergy 62(6):668–674PubMedCrossRefGoogle Scholar
  7. Chrystyn H, Small M, Milligan G, Higgins V, Gil EG, Estruch J (2014) Impact of patients’ satisfaction with their inhalers on treatment compliance and health status in COPD. Respir Med 108(2):358–365PubMedCrossRefGoogle Scholar
  8. Dhamane AD, Schwab P, Hopson S, Moretz C, Annavarapu S, Burslem K, Renda A, Kaila S (2017) Association between adherence to medications for COPD and medications for other chronic conditions in COPD patients. Int J Chron Obstruct Pulmon Dis 12:115–122PubMedCrossRefGoogle Scholar
  9. DiMatteo MR (2004) Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 42(3):200–209PubMedCrossRefGoogle Scholar
  10. Dudvarski Ilic A, Zugic V, Zvezdin B, Kopitovic I, Cekerevac I, Cupurdija V, Perhoc N, Veljkovic V, Barac A (2016) Influence of inhaler technique on asthma and COPD control: a multicenter experience. Int J Chron Obstruct Pulmon Dis 11:2509–2517PubMedPubMedCentralCrossRefGoogle Scholar
  11. George J, Kong DC, Thoman R, Stewart K (2005) Factors associated with medication nonadherence in patients with COPD. Chest 128(5):3198–3204PubMedCrossRefGoogle Scholar
  12. Ivanov Y, Nikolaev I, Nemeth I (2018) Real-life evaluation of COPD treatment in a Bulgarian population: a 1-year prospective, observational, noninterventional study. Int J Chron Obstruct Pulmon Dis 13:653–663PubMedPubMedCentralCrossRefGoogle Scholar
  13. Jouleh B, Erdal M, Eagan TM, Bakke P, Gulsvik A, Nielsen R (2018) Guideline adherence in hospital recruited and population-based COPD patients. BMC Pulm Med 18(1):195PubMedPubMedCentralCrossRefGoogle Scholar
  14. Khadour MR, Hawwa AF, Kidney JC, Smyth BM, McElnay JC (2012) Potential risk factors for medication non-adherence in patients with chronic obstructive pulmonary disease (COPD). Eur J Clin Pharmacol 68(10):1365–1373CrossRefGoogle Scholar
  15. Kokturk N, Polatli M, Oguzulgen IK, Saleemi S, Al Ghobain M, Khan J, Doble A, Tariq L, Aziz F, El Hasnaoui A (2018) Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study. Int J Chron Obstruct Pulmon Dis 13:1377–1388PubMedPubMedCentralCrossRefGoogle Scholar
  16. Leiva-Fernández J, Leiva-Fernández F, García-Ruiz A, Prados-Torres D, Barnestein-Fonseca P (2014) Efficacy of a multifactorial intervention on therapeutic adherence in patients with chronic obstructive pulmonary disease (COPD): a randomized controlled trial. BMC Pulm Med 14:70PubMedPubMedCentralCrossRefGoogle Scholar
  17. Liao KM, Chen CY (2019) The association between adherence and dementia in chronic obstructive pulmonary disease. Medicine (Baltimore) 98(20):e15646CrossRefGoogle Scholar
  18. Lutje V (2019) Guide to the search strategy. https://cidg.cochrane.org. Accessed on 02 Jan 2019
  19. Mısırlıgil Z, Çımrın A, Günen H, Özlü T, Çilli A, Akyıldız L, Bayram H, Gemicioğlu B, Uzaslan E, Abadoğlu Ö, Suerdem M (2017) Real life profile of asthma and chronic obstructive pulmonary disease patients in Turkey. Tuberk Toraks 65(3):169–179PubMedCrossRefGoogle Scholar
  20. Montes de Oca M, Menezes A, Wehrmeister FC, Lopez Varela MV, Casas A, Ugalde L, Ramirez-Venegas A, Mendoza L, López A, Surmont F, Miravitlles M (2017) Adherence to inhaled therapies of COPD patients from seven Latin American countries: the LASSYC study. PLoS One 12(11):e0186777PubMedPubMedCentralCrossRefGoogle Scholar
  21. Morisky DE, Ang A, Krousel-Wood M, Ward HJ (2008) Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 10(5):348–354CrossRefGoogle Scholar
  22. Moy ML, Martinez CH, Kadri R, Roman P, Holleman RG, Kim HM, Nguyen HQ, Cohen MD, Goodrich DE, Giardino ND, Richardson CR (2016) Long-term effects of an internet-mediated pedometer-based walking program for chronic obstructive pulmonary disease: randomized controlled trial. J Med Internet Res 18(8):e215PubMedPubMedCentralCrossRefGoogle Scholar
  23. Müllerová H, Landis SH, Aisanov Z, Davis KJ, Ichinose M, Mannino DM, Maskell J, Menezes AM, van der Molen T, Oh YM, Tabberer M, Han MK (2016) Health behaviors and their correlates among participants in the continuing to confront COPD International Patient Survey. Int J Chron Obstruct Pulmon Dis 11:881–890. Erratum in: Int J Chron Obstruct Pulmon Dis 12:859Google Scholar
  24. Ngo CQ, Phan DM, Vu GV, Dao PN, Phan PT, Chu HT, Nguyen LH, Vu GT, Ha GH, Tran TH, Tran BX, Latkin CA, Ho CSH, Ho RCM (2019) Inhaler technique and adherence to inhaled medications among patients with acute exacerbation of chronic obstructive pulmonary disease in Vietnam. Int J Environ Res Public Health 16(2):pii: E185CrossRefGoogle Scholar
  25. Nguyen TS, Nguyen TLH, Pham TTV, Hua S, Ngo QC, Li SC (2019) Impact of pharmaceutical care in the improvement of medication adherence and quality of life for COPD patients in Vietnam. Respir Med 153:31–37PubMedCrossRefGoogle Scholar
  26. Olszanecka-Glinianowicz M, Almgren-Rachtan A (2014) The adherence and illness perception of patients diagnosed with asthma or chronic obstructive pulmonary disease treated with polytherapy using new generation cyclohaler. Postepy Dermatol Alergol 31(4):235–246PubMedPubMedCentralCrossRefGoogle Scholar
  27. Pinnock H, Hanley J, McCloughan L, Todd A, Krishan A, Lewis S, Stoddart A, van der Pol M, MacNee W, Sheikh A, Pagliari C, McKinstry B (2013) Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ 347:f6070PubMedPubMedCentralCrossRefGoogle Scholar
  28. Plaza V, Fernández-Rodríguez C, Melero C, Cosío BG, Entrenas LM, de Llano LP, Gutiérrez-Pereyra F, Tarragona E, Palomino R, López-Viña A, TAI Study Group (2016a) Validation of the ‘Test of the Adherence to Inhalers’ (TAI) for asthma and COPD patients. J Aerosol Med Pulm Drug Deliv 29(2):142–152PubMedPubMedCentralCrossRefGoogle Scholar
  29. Plaza V, López-Viña A, Entrenas LM, Fernández-Rodríguez C, Melero C, Pérez-Llano L, Gutiérrez-Pereyra F, Tarragona E, Palomino R, Cosio BG (2016b) Differences in adherence and non-adherence behaviour patterns to inhaler devices between COPD and asthma patients. COPD 13(5):547–554PubMedCrossRefGoogle Scholar
  30. Poureslami I, Kwan S, Lam S, Khan NA, FitzGerald JM (2016) Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial. Int J Chron Obstruct Pulmon Dis 11:1811–1822PubMedPubMedCentralCrossRefGoogle Scholar
  31. R Core Team (2019) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/. Accessed on 22 Jan 2019
  32. Sanduzzi A, Balbo P, Candoli P, Catapano GA, Contini P, Mattei A, Puglisi G, Santoiemma L, Stanziola AA (2014) COPD: adherence to therapy. Multidiscip Respir Med 9:60PubMedPubMedCentralCrossRefGoogle Scholar
  33. Świątoniowska N, Dudek K, Szymczyk A, Jankowska-Polańska B (2018) Factors associated with adherence in patients with type 2 diabetes mellitus. J Educ Health Sport 8(12):192–209Google Scholar
  34. Tommelein E, Mehuys E, Van Hees T, Adriaens E, Van Bortel L, Christiaens T, Van Tongelen I, Remon JP, Boussery K, Brusselle G (2014) Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease (PHARMACOP): a randomized controlled trial. Br J Clin Pharmacol 77(5):756–766PubMedPubMedCentralCrossRefGoogle Scholar
  35. Toyama T, Kawayama T, Kinoshita T, Imamura Y, Yoshida M, Takahashi K, Fujii K, Higashimoto I, Hoshino T (2019) Differences In adherence barriers to inhaled medicines between Japanese patients with chronic obstructive pulmonary disease and asthma evaluated using the ‘Adherence Starts with Knowledge 20’ (ASK-20) questionnaire. Intern Med 58(2):175–185PubMedCrossRefGoogle Scholar
  36. Tran M, Xiang P, Rascati KL, Stock EM, Godley PJ, Coleman A, Bogart MR, Stanford RH (2016) Predictors of appropriate pharmacotherapy management of COPD exacerbations and impact on 6-month readmission. J Manag Care Spec Pharm 22(10):1186–1193PubMedGoogle Scholar
  37. van der Palen J, Cerveri I, Roche N, Singh D, Plaza V, Gonzalez C, Patino O, Scheepstra I, Safioti G, Backer V (2019) DuoResp® Spiromax® adherence, satisfaction and ease of use: findings from a multi-country observational study in patients with asthma and COPD in Europe (SPRINT). J Asthma 11:1–9CrossRefGoogle Scholar
  38. Vestibo J, Anderson JA, Calverley P, Celli B, Ferguson GT, Jenkins C, Knobil K, Willits LR, Yates JC, Jones PW (2009) Adherence to inhaled therapy, mortality and hospital admission in COPD. Thorax 64(11):939–943CrossRefGoogle Scholar
  39. WHO (2003) Adherence to long-term therapies – evidence for action. Essential medicines and health products information portal. A World Health Organization resource. https://apps.who.int/medicinedocs/en/d/Js4883e/8.5.4.html. Accessed on 22 Oct 2019
  40. Wiśniewski D, Porzezińska M, Gruchała-Niedoszytko M, Niedoszytko M, Slominski JM, Jassem E (2014) Factors influencing adherence to treatment in COPD patients and its relationship with disease exacerbations. Pneumonol Alergol Pol 82(2):96–104CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Natalia Świątoniowska
    • 1
  • Mariusz Chabowski
    • 2
  • Jacek Polański
    • 3
  • Grzegorz Mazur
    • 3
  • Beata Jankowska-Polańska
    • 1
    Email author
  1. 1.Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health ScienceWroclaw Medical UniversityWroclawPoland
  2. 2.Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health ScienceWroclaw Medical UniversityWroclawPoland
  3. 3.Department and Clinic of Internal and Occupational Diseases and HypertensionWrocław Medical UniversityWroclawPoland

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