Status of and strategies for improving adherence to COPD treatment

Figures & data

Figure 1 Concepts pertaining to the evaluation of adherence. Adapted with permission from Vrijens B, De Geest S, Hughes DA, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73(5):691–705. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.⁸

Table 1 Methods of evaluating medication adherence in COPD at the patient level

		Direct methods	Indirect methods
Subjective			Patient questionnaires Patient diaries
Objective	Clinical monitoring	Directly observed therapy	Dose count
	Electronic monitoring	Electronic microchip	Medication event monitoring systems Electronic devices
Biochemical monitoring	Measurement of the medication or its metabolite in urine, serum or tissues	Measurement of biological markers

Figure 2 The INCA system. which is an open-access article distributed under the terms of the creative commons attribution license, permitting its unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Note: Reproduced from D’Arcy S, MacHale E, Seheult J, Holmes MS, Hughes C, Sulaiman I, et al. A method to assess adherence in inhaler use through analysis of acoustic recordings of inhaler events. PLoS One. 2014;9(6): e98701. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode.³⁵

Box 1 Factors associated with treatment adherence

Age

Gender

Education

Race

Number of concomitant treatments

Disease severity

Smoking status

Satisfaction with the inhaler

Type of inhaler device

Number of inhalers

Satisfaction with drug efficacy

Satisfaction with clinician expertise

Socioeconomic factors

Social/familial support

Dose regimen

Specific comorbidities

Health literacy

Vrijens B, De Geest S, Hughes DA, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73(5):691–705.22486599

 PubMed Web of Science ®Google Scholar

D’Arcy S, MacHale E, Seheult J, et al. A method to assess adherence in inhaler use through analysis of acoustic recordings of inhaler events. PLoS One. 2014;9(6):e98701. doi:10.1371/journal.pone.009870124905012

 PubMed Web of Science ®Google Scholar