Adherence to COPD treatment: Myth and reality (article from 2017 Respiratory Medicine)

Great Respiratory article from our Italian Friends!!! 

Highlights 

• The level of medication adherence in COPD patients is very low

• Approaches to assess adherence of COPD are burdened with important limitations. 

• Patient views on therapy effectiveness are powerful predictors of reported adherence. 

• The physician can affect adherence in COPD with his/her prescription. 

• In COPD, adherence to inhalation medication is device-related.

COPD is a chronic disease in which effective management requires long-term adherence to pharmacotherapies but the level of adhesion to the prescribed medications is very low and this has a negative influence on outcomes. There are several approaches to detect non-adherence, such as pharmacy refill methods, electronic monitoring, and self-report measures, but they are all burdened with important limitations. Medication adherence in COPD is multifactorial and is affected by patients (health beliefs, cognitive abilities, self-efficacy, comorbidities, psychological profile, conscientiousness), physicians (method of administration, dosing regimen, polypharmacy, side effects), and society (patient-prescriber relationship, social support, access to medication, device training, follow-up). Patient-health care professional communication, especially that between patient and physician or pharmacist, is central to optimizing patient adherence. However, the most realistic approach is to keep in mind that non-adherence is always possible, indeed, probable.

Article is HERE!!! 

To sleep, or not to sleep – that is the question, for polysomnography (Free full text from Breathe)

As the English dramatist Thomas Dekker wrote, “Sleep is that golden chain that ties health and our bodies together”. One of the most frequently sleep-related disorders (SRD) is obstructive sleep apnoea syndrome (OSAS). OSAS is a relatively “young” disease and at the same time, one of the most important respiratory conditions discovered in the last 50 years due to its incidence, prevalence, health-related impact on the patient’s life and economic burden.

Nevertheless, 50 years is still a large amount of time and our understanding of OSAS has grown significantly over these years. The first reports discussed how to diagnose this rare condition. Later, it was demonstrated that the disease itself is not that rare and is extremely underdiagnosed. This was only the tip of the iceberg, since it was furthermore discovered that OSAS is linked to multiple comorbidities and is a major healthcare problem. Now, we are moving further forward, and discussing more efficient ways to diagnose and manage this condition.

Free full text:

http://breathe.ersjournals.com/content/13/2/137