Cited by 490Medication Adherence and ComplianceChronic Obstructive Pulmonary Disease (COPD) ResearchPharmacy and Medical Practices

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Patient adherence in COPD

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Bourbeau, J, Bartlett, S J·2008·Thorax

DOI 10.1136/thx.2007.086041PMC PMC4747423

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Abstract

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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Background
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Additional file 3 of Severity distribution and treatment of chronic obstructive pulmonary disease in China: baseline results of an observational study
Yang, T., 蔡柏蔷, Cao, B., Kang, J., Wen, F., Chen, Y., 简文华, Shang, H., & Wang, C. (2022) · Figshare · doi:10.6084/m9.figshare.19687220
Additional file 1 of Sociodemographic inequities in unscheduled asthma care visits among public assistance recipients in Japan: additional risk by household composition among workers
Nishioka, D., Saito, J., Ueno, K., & Kondo, N. (2024) · Figshare · doi:10.6084/m9.figshare.26625886
Additional file 1 of Navafenterol (AZD8871) in patients with mild asthma: a randomised placebo-controlled phase I study evaluating the safety, tolerability, pharmacokinetics, and pharmacodynamics of single ascending doses of this novel inhaled long-acting dual-pharmacology bronchodilator
Jimenez, E., Astbury, C., Albayaty, M., Hamrén, U. W., Seoane, B., Villarroel, C., Pujol, H., Bermejo, M. J., Ajay, A., & Psallidas, I. (2020) · Figshare · doi:10.6084/m9.figshare.12936335
Additional file 1 of Cost-related medication nonadherence in adults with COPD in the United States 2013–2020
Wen, X., Qiu, H., Yu, B., Bi, J., Gu, X., Zhang, Y., & Wang, S. (2024) · Figshare · doi:10.6084/m9.figshare.26696001
Additional file 2 of Severity distribution and treatment of chronic obstructive pulmonary disease in China: baseline results of an observational study
Yang, T., 蔡柏蔷, Cao, B., Kang, J., Wen, F., Chen, Y., Jian, W., Shang, H., & Wang, C. (2022) · Figshare · doi:10.6084/m9.figshare.19687217
Additional file 1 of Severity distribution and treatment of chronic obstructive pulmonary disease in China: baseline results of an observational study
Yang, T., 蔡柏蔷, Cao, B., Kang, J., Wen, F., Chen, Y., Jian, W., Shang, H., & Wang, C. (2022) · Figshare · doi:10.6084/m9.figshare.19687214
The impact of stepping up treatment from LABA/LAMA to extrafine single inhaler triple therapy on exacerbations of Greek patients with Chronic Obstructive Pulmonary Disease: The IMPROVE study
Kosmas, E., Bartziokas, Κ., Loukides, S., Bakakos, P., Rovina, N., Georgatou, N., Papapetrou, D., Katerelos, P., Papapostolou, E., Efstathopoulos, P., et al. (2026) · Respiratory Medicine · doi:10.1016/j.rmed.2026.108682
Cluster Analysis of Healthcare Utilization Patterns in Patients with Comorbid Chronic Obstructive Pulmonary Disease and Atrial Fibrillation
Kotlyarov, S. N., & Lyubavin, A. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15041444
“It is known that COPD patients’ adherence to treatment varies, many COPD patients do not receive adequate treatment, and non-compliance with the treatment regimen can lead to hospitalizations [22–24].”
Soutenir l'engagement des usagers de la santé dans leur parcours de soin par la reconnaissance des savoirs expérientiels de la maladie : étude à partir de l'exploration du vécu des patients atteints de broncho-pneumopathie chronique obstructive
Bremond, M. (2024) · theses.fr (ABES) · doi:10.70675/ca5cb2c4z19c5z40dbz9ea3z31362e436204
Recruitment for a digitally based follow-up program for people with chronic obstructive pulmonary disease: a pilot cluster randomized controlled trial
Kvidaland, H. K., Iversen, M. M., Frisk, B., Richards, D. A., Lomborg, K., Borge, C. R., & Kolltveit, B. H. (2026) · Pilot and Feasibility Studies · doi:10.1186/s40814-026-01832-8
An Italian regional analysis on chronic obstructive pulmonary disease (COPD): correct diagnosis and lifestyle play a fundamental role in supporting drug therapy and containing healthcare costs
Ferrara, F., Berardinis, F. D., Scognamiglio, M., & Zovi, A. (2026) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-026-05597-y
Once-daily vilanterol-fluticasone versus twice-daily formoterol-fluticasone in chronic obstructive pulmonary diseases: Real-world evidence on dosing frequency, adherence, and clinical outcomes
Garg, R., Prakash, P., Butola, M., & Kishore, R. (2026) · Medicine India · doi:10.25259/medindia_11_2026
Improving diagnostic appropriateness and healthcare governance in COPD management: evidence from a primary care network with integrated spirometry in Italy
Ferrara, F., Berardinis, F. D., Scognamiglio, M., & Zovi, A. (2026) · Ethics Medicine and Public Health · doi:10.1016/j.jemep.2026.101326

Authors: Bourbeau, J., & Bartlett, S. J.
Affiliations: McGill University Health Centre (CA)
Johns Hopkins University (US)
Corresponding author: Bourbeau, J
ORCID: Bourbeau, J
Bartlett, S J
Venue: Thorax
Publisher: BMJ
Published: 2008-09-01
Volume: 63
Issue: 9
Pages: 831-838
ISSN: 0040-6376 (ISSN-L)
DOI: 10.1136/thx.2007.086041
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
Health Sciences › Health Professions › Pharmacy › 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

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