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- Title
ADHERENCE TO TREATMENT OF COPD PATIENTS.
- Authors
Chiș, Ana; Ianosi, Edit Simona; Jimborean, Gabriela
- Abstract
Introduction: Chronic Obstructive Pulmonary disease (COPD) is a worldwide severe obstructive disease with high impact over people's health and society. Despite the progresses made in the medical treatment there are some dysfunctionality in the management of this patients especially concerning adherence to medication treatment (inhalators, smoking cessation, oxygen therapy, CPAP therapy) and respiratory rehabilitation (exercise, education, diet, auto-management of the disease). Nonadherence could manifest by underuse, overuse or improper use of a medication or disregarding medical recommendations (continuing smoking, exposure to noxious, lack of exercise). The main causes of nonadherence (NA) are due directly to the patient (noncompliance) or indirectly due to the physicians' lack of engagement or due to high cost of medication. In COPD NA to treatment and medical advice brings more symptoms, increase number of exacerbation/hospitalizations, decrease quality of life, provide complications and increase mortality. In the same time, for the patient NA to treatment means lack of self - care. The efficacy of the treatment relies also on patients' adherence to the medical advice, and education for aggravation/complication prophylaxis. At the moment of the diagnosis and start of treatment the physician would explain the necessity for a life-time treatment, smoking cessation and medication consisting mainly in bronchodilators. After a large discussion with the patient and his family, the physician will ensure a written plan of treatment and would explain the type of the disease, the reason and the benefices of the treatment, its lack of dangers, the technique of inhalation, and the possible side effects and will demonstrate the administration technique. Than the patient will repeat the goal of treatment and he will demonstrate how he should take the inhalers. The patient will respect the schedule of the future visits to the pulmonologist. At each visit the pulmonologist will check the patient compliance and the technique of drug administration. Conclusion: The patient has to become an active actor in his own health management. The physician will adapt the treatment to the accessible medication, to the patient's belief and cognitive ability. Nowadays it speaks about "concordance" between patient and healthcare professional. From the health-system point of view NA could mean a great burden with healthcare expenditure and direct cost (associated with medical resource use, efforts from the medical personnel) and indirect costs (by absenteeism, work loss, worker replacement, reduced productivity, and family care). The strategy to increase adherence continue to be largely studied but consists in some ideas: treatment (by written plan) has to be simple (one dose daily), simply explained to the patient and to his family, adapted to the patient abilities and financial possibilities, with follow-up supervision and enforcing self-management.
- Subjects
MEDICAL personnel; OBSTRUCTIVE lung diseases; PATIENT compliance; MEDICAL care costs
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p22
- ISSN
2068-3324
- Publication type
Article