Patient adherence in COPD
Open accessAbstract
Patient adherence to treatment in chronic obstructive pulmonary disease (COPD) is essential to optimise disease management. As with other chronic diseases, poor adherence is common and results in increased rates of morbidity, healthcare expenditures, hospitalisations and possibly mortality, as well as unnecessary escalation of therapy and reduced quality of life. Examples include overuse, underuse, and alteration of schedule and doses of medication, continued smoking and lack of exercise. Adherence is affected by patients' perception of their disease, type of treatment or medication, the quality of patient provider communication and the social environment. Patients are more likely to adhere to treatment when they believe it will improve disease management or control, or anticipate serious consequences related to non-adherence. Providers play a critical role in helping patients understand the nature of the disease, potential benefits of treatment, addressing concerns regarding potential adverse effects and events, and encouraging patients to develop self-management skills. For clinicians, it is important to explore patients' beliefs and concerns about the safety and benefits of the treatment, as many patients harbour unspoken fears. Complex regimens and polytherapy also contribute to suboptimal adherence. This review addresses adherence related issues in COPD, assesses current efforts to improve adherence and highlights opportunities to improve adherence for both providers and patients.
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Previous studies suggested that misuse or rejection of medication or NIV can be influenced by psychological factors such as anxiety, depression, health beliefs, and cognitive impairment.
“Previous studies suggested that the misuse or rejection of medication or NIV can be influenced by some psychological factors such as anxiety, depression, health beliefs, and cognitive impairment (27–29); the unacknowledged recognition of the illness; and the use of different devices and medications due to comorbidities (30–32).”
From Promoting Acceptance and Adherence to Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. (2022) · cites this paper as [28]
In “Determinants of adherence” (page unavailable), the paper links disease perceptions, depression, and cognitive impairment to medication non-adherence. It reports anxiety in patients with COPD but does not link anxiety directly to adherence; the passages on nebuliser/intermittent positive-pressure breathing therapy do not establish the claimed factors for NIV specifically. (LLM, conf=0.86)
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- Authors
- Bourbeau, J., & Bartlett, S. J.
- Affiliations
- McGill University Health Centre (CA)
- Johns Hopkins University (US)
- Corresponding author
- Bourbeau, J
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2008-09-01
- Volume
- 63
- Issue
- 9
- Pages
- 831-838
- ISSN
- 0040-6376 (ISSN-L)
- PMC
- PMC4747423
- OpenAlex
- W2138833643
- Cited by
- 490
- References
- 101
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 25 · 2023: 22 · 2022: 24 · 2021: 32 · 2020: 30 · 2019: 24 · 2018: 42 · 2017: 34 · 2016: 37 · 2015: 23 · 2014: 37 · 2013: 41 · 2012: 24
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- McGill University
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR051351)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- chronic obstructive pulmonary disease, medication adherence, patient-provider communication, self-management, polypharmacy, complex medication regimens, smoking, health care utilization, quality of life
- MeSH terms
- Attitude to Health, Communication, Humans, Patient Compliance, Perception, Professional-Patient Relations, Caregivers, Polypharmacy, Pulmonary Disease, Chronic Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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