The importance of medication adherence in patients with respiratory diseases
The importance of
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Taking medication correctly may seem as a simple task, but not taking the medication as directed occurs more often than we would like, and this can result in complications and damage for the patient. This is particularly a challenge for those patients with chronic conditions (for example, asthma and chronic obstructive pulmonary disease or COPD), that require multiple medications for its management and may result in serious consequences if not taken as directed. Forgetting to take their medications, fear of side effects and prescription costs may be some of the reasons patients do not take their medications correctly. General medicine reviews estimate that approximately 50% of medications for chronic disease are not taken as prescribed. Adherence rates tend to be even lower for patients with asthma or COPD, with estimates ranging widely from 22% to 78%.
What is medication adherence?
The American Pharmacist Association states that medication adherence is the extent to which a patient’s behavior (e.g. taking medications with respect to timing, dosage and frequency) corresponds with agreed-upon recommendations from a healthcare provider. A patient is considered adherent if they take 80% of their prescribed medicine (s).1
Examples of nonadherence can include delaying or not filling a prescription, skipping doses, splitting pills, or stopping a medication early.2
Chronic respiratory diseases such as asthma and COPD, are managed by the use of inhaled medication. An effective treatment of these diseases, requires the patient to be adherent to the medication they are taking. For example, in asthma patients the regular use of the controller medication, even when symptoms are infrequent, can improve symptom control and avoid complications from the disease. Greater adherence can result in better health outcomes, which can include disease control, and a reduction in the amount of exacerbations and hospitalizations and mortality.
Factors that do not help with medication adherence in patients with asthma and COPD:
- Medication related – complex regimen due to multiple medication use, efficacy, side effects, inhaler technique, cost
- Patient related – believe that the treatment is not necessary, not understanding how to take the medication, forgetting to take the medication, age related factors and other comorbidities, denial of the disease, cultural/religious issues
How to improve medication adherence?
Good communication with healthcare providers – Adherence should be assessed from the first time you get a new prescription and over the course of treatment. This helps to make sure you understand how to take your medication, and communicate if you are experiencing any side effects. It is important to discuss with your physician the results you will be expecting from the treatment and establish goals to improve your condition.
The best way to address adherence is to discuss medication taking behaviors directly with your physician. Establishing a strong relationship with your healthcare providers will allow you to not be afraid to ask any questions and express any concerns about the medications you are taking.
Training on correct inhaler technique – The physician should assess your inhaler technique and symptom improvement in every visit. The patient must learn how the device works to improve lung function, be taught on how to use the device with the correct technique, and be offered additional training and education if necessary. A proper inhaler technique will increase adherence to the medication and improve therapeutic outcomes.
Use of technology – Electronic medication reminders can help improve forgetfulness in taking inhaled medications. Some devices are available with smartphone applications, which patients have reported to be helpful in taking the medication as prescribed.
Medication adherence can make an impact on your quality of life, health outcomes, and healthcare costs. Working together with your healthcare provider is essential to achieve medication adherence, control your respiratory disease, and reduce symptoms and future risk of exacerbations.
- Hugtenburg JG, Timmers L, Elders P, Vervloet M, van Dijk L. Definitions, variants, and causes of nonadherence with medication: a challenge for tailored interventions. Patient Prefer Adherence. 2013;7:675-682 https://doi.org/10.2147/PPA.S29549
- . “Medication Adherence”. American Pharmacists Association. https://www.pharmacist.com/medication-adherence. Accessed October 6, 2020
- George, M., & Bender, B. (2019). New insights to improve treatment adherence in asthma and COPD. Patient preference and adherence, 13, 1325–1334. https://doi.org/10.2147/PPA.S209532