Medication adherence issues in patients treated for COPD
Open accessAbstract
Although medical treatment of COPD has advanced, nonadherence to medication regimens poses a significant barrier to optimal management. Underuse, overuse, and improper use continue to be the most common causes of poor adherence to therapy. An average of 40%-60% of patients with COPD adheres to the prescribed regimen and only 1 out of 10 patients with a metered dose inhaler performs all essential steps correctly. Adherence to therapy is multifactorial and involves both the patient and the primary care provider. The effect of patient instruction on inhaler adherence and rescue medication utilization in patients with COPD does not seem to parallel the good results reported in patients with asthma. While use of a combined inhaler may facilitate adherence to medications and improve efficacy, pharmacoeconomic factors may influence patient's selection of both the device and the regimen. Patient's health beliefs, experiences, and behaviors play a significant role in adherence to pharmacological therapy. This manuscript reviews important aspects associated with medication adherence in patients with COPD and identifies some predictors of poor adherence.
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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 [27]
The Summary and “Patient beliefs, experiences, and behaviors” sections link depression and health beliefs to medication adherence in patients with COPD. The passages found do not establish the claimed effects of anxiety or cognitive impairment, or extend those factors to rejection of noninvasive ventilation; the device discussion concerns inhalers and nebulizers instead. Page numbers were not available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredUsing NIV requires behavioural and lifestyle changes, such as allocating time for ventilation, and this may reduce adherence to treatment.
“Using NIV requires the patient to make some behavioural and lifestyle changes, such as changes in daily routine to allocate time for ventilation, and this may reduce adherence to the treatment [24].”
From A psychological intervention to promote acceptance and adherence to non-invasive ventilation in people with chronic obstructive pulmonary disease: study protocol of a randomised controlled trial. (2017) · cites this paper as [24]
The Introduction to management issues in COPD says treatment can require behavioural and lifestyle changes, and Patient beliefs, experiences, and behaviors links interference with daily activities to adherence. The paper discusses medication and aerosol-device treatment, however, not whether NIV requires patients to allocate time for ventilation or whether that specific demand reduces adherence. Page numbers are not available in our copy. (LLM, conf=0.83)
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- Authors
- Restrepo, R.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Corresponding author
- Restrepo, Ruben
- ORCID
- Restrepo, Ruben
- Venue
- International Journal of Chronic Obstructive Pulmonary Disease
- Publisher
- Informa UK Limited
- Published
- 2008-09
- Volume
- Volume 3
- Issue
- 3
- Pages
- 371-384
- ISSN
- 1176-9106 (ISSN-L)
- 1178-2005
- PMC
- PMC2629978
- OpenAlex
- W1479859260
- Cited by
- 407
- References
- 114
- Citations by year
- 2026: 14 · 2025: 12 · 2024: 18 · 2023: 21 · 2022: 26 · 2021: 23 · 2020: 35 · 2019: 32 · 2018: 34 · 2017: 31 · 2016: 32 · 2015: 20 · 2014: 33 · 2013: 23 · 2012: 15
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of COPD (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- 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 › Medicine › Pulmonary and Respiratory Medicine › Inhalation and Respiratory Drug Delivery
- Keywords
- chronic obstructive pulmonary disease, medication adherence, inhaler technique, MDI, rescue medication use, patient education, health beliefs, predictors of non-adherence, pharmacoeconomics, primary care
- MeSH terms
- Hospitalization, Humans, Patient Education as Topic, Quality of Life, Health Behavior, Patient Satisfaction, Economics, Pharmaceutical, Pulmonary Disease, Chronic Obstructive, Metered Dose Inhalers, Medication Adherence
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.
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