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LETTER TO THE EDITOR
Year : 2011  |  Volume : 6  |  Issue : 4  |  Page : 242-243
Effect of patient education on adherence to drug treatment for chronic obstructive pulmonary disease


Department of Rehabilitation, Pulmonary Rehabilitation Unit, ICP Hospital, Milan, Italy

Date of Web Publication12-Sep-2011

Correspondence Address:
C Incorvaia
Department of Rehabilitation, Pulmonary Rehabilitation Unit, ICP Hospital, Milan
Italy
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DOI: 10.4103/1817-1737.84783

PMID: 21977074

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How to cite this article:
Incorvaia C, Riario-Sforza G G. Effect of patient education on adherence to drug treatment for chronic obstructive pulmonary disease. Ann Thorac Med 2011;6:242-3

How to cite this URL:
Incorvaia C, Riario-Sforza G G. Effect of patient education on adherence to drug treatment for chronic obstructive pulmonary disease. Ann Thorac Med [serial online] 2011 [cited 2019 Nov 19];6:242-3. Available from: http://www.thoracicmedicine.org/text.asp?2011/6/4/242/84783


Sir,

The adherence to drug treatment that was recently globally estimated in less than 50% is a major issue in medicine. [1] This is also true concerning drugs used in patients with chronic obstructive pulmonary disease (COPD). [2] Patient education is the most appropriate intervention to improve adherence and its implementation in current management of COPD is a need to meet. [3]

We have evaluated the changes in the adherence to drug treatment in patients with COPD receiving a complete educational program. From patients referring for the first time to the outpatient setting of our pulmonary rehabilitation unit we included in the study the first 100 patients who were prescribed by their primary care physician a drug treatment according to the updated version of the guidelines on obstructive lung disease (GOLD). [4] In particular, 28% of patients were treated by inhaled long acting beta2 agonists (LABA), 31% by tiotropium, 26% by LABA plus inhaled corticosteroids (ICS), 8% by tiotropium plus ICS, and 7% by LABA, tiotropium, and ICS.

At admission, 34% of patients had stopped one or more of the prescribed drugs without physician's authorization, and 53% did not use the correct dosage. This defines a compliance of 66% and an adherence of 47%. In addition, only 24% of patients showed a correct inhalation technique.

All patients underwent a pulmonary rehabilitation (PR) program based on 10 sessions with physical exercise, respiratory exercise, and education on COPD. The latter included a detailed explanation on aims and outcomes of drugs for COPD and training to learn to apply the correct inhalation technique.

After 6 months, 95 patients attended the subsequent PR course. The 5 patients who did not attend were contacted by phone: all were continuing the drug treatment, but only 2 used the correct doses. Of the 95 patients continuing PR, 3 (3.2%) had stopped one or more drugs, and 12 (12.6%) did not follow the correct dosage. This defines a compliance of 96.8% and an adherence of 87.4%. Therefore, patient education is able to greatly improve compliance and adherence to the prescribed drugs in patients with COPD. Such outcome should stimulate to expand the application of patient education in management of COPD patients.

 
   References Top

1.Cutler DM, Everett W. Thinking outside the pillbox-medication adherence as a priority for health care reform. N Engl J Med 2010;362:1553-5.  Back to cited text no. 1
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2.Bourbeau J, Bartlett SJ. Patient adherence in COPD. Thorax 2008;63:831-8.  Back to cited text no. 2
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3.Yawn BP, Wollan PC. Knowledge and attitudes of family physicians coming to COPD continuing medical education. Int J Chron Obstruct Pulmon Dis 2008;3:311-7.  Back to cited text no. 3
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4.Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al . Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532-55.  Back to cited text no. 4
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