Therapeutic adherence improves when the inhaler is chosen in a consensual manner between the doctor and the patient.
Sccording to the estimates of the World Health Organization (WHO), more than 50% of chronic patients do not have correct adherence to treatment. In the case of respiratory pathologies, such as asthma and COPD, reversing low therapeutic adherence is one of the main challenges for disease control, prognosis, and quality of life.
“Low adherence is a problem that worsens in the context of respiratory pathologies because monitoring and consistency in treatment with inhalers is more complicated than with tablets,” explains Vicente Plaza, director of the Hospital de la Santa Pneumology Service. Creu i Sant Pau of Barcelona.
Treatment non-compliance is related to a loss of effectiveness in treatments and an increase in healthcare costs. “Professionals must be aware and correctly assess whether the patient is complying with the prescribed doses,” says the pulmonologist, who also recalls that the patient himself must be involved.
For its part, the choice of treatment and device must be agreed upon to improve disease control and adherence. “You have to try to use easy-to-follow treatments. Studies have shown that adherence improves when the inhaler is chosen jointly by the doctor and the patient”, adds Plaza.
In this sense, the correct functioning of the device also depends on the information and training that the patient receives. “Nursing plays a fundamental role in the task of informing, motivating and empowering the patient, encouraging them to play an active role and be the protagonist of their health, a key element to promote adherence”, explains Isabel Portela, coordinator of the Sleep Interest Group. and TRD of the Nursing Area of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).
For this reason, the multidisciplinary team must function “as a block” and in perfect communication harmony. “The hospital pharmacist can complement the team by investing time in helping the patient to take their medication properly, but also in detecting side effects or possible interactions with other drugs,” describes Mar Gomis-Pastor, clinical specialist pharmacist and director of the Digital Health Unit and the Center for Clinical Validation of Digital Solutions of the Hospital de la Santa Creu i Sant Pau. It is important to remember that adherence not only has a huge impact on the patient, but also improves the economic sustainability of the National Health System (SNS). “Increased adherence to treatment is essential to avoid symptoms and keep the patient out of the hospital, especially in pandemic waves,” says Portela.
For their part, specialists insist on promoting campaigns to improve this situation. “There are studies that support that therapeutic adherence is cost-efficient. Therefore, generalized programs should be carried out from the SNS and not fragmented initiatives from the centers”, concludes the pharmacist. M.T.T. MADRID