Medication Adherence Issues to Inhaled Therapy and Their Impact on Lung Diseases

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmaceutical Technology".

Deadline for manuscript submissions: closed (15 January 2024) | Viewed by 7039

Special Issue Editors


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Guest Editor
Unit of Pharmaceutics and Biopharmaceutics, Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles,1050 Brussels, Belgium
Interests: dry powder for inhalation; nanomedicine; cancer; asthma; COPD; lung infections; controlled release; targeting

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Guest Editor
Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
Interests: medication review; medication adherence; community pharmacy; clinical pharmacy; drug-related problems; implementation science

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Guest Editor
Food and Drug Department, University of Parma, 43124 Parma, Italy
Interests: dry powder inhaler; particle engineering; inhalation therapy; high drug dose
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Special Issue Information

Dear Colleagues,

“In lung diseases that require chronic treatment such as asthma, COPD or cystic fibrosis,  adherence to inhaled treatments is often poor, leading to poor disease control and exacerbations. Moreover, adherence to the maintenance treatment is more difficult as the patient does not directly feel the benefits on their health status. Moreover, the healthcare professional prescribes the more appropriate medicine for the patient according to the recommendations, but this is sometimes not understandable or not always the easiest for the patient.

Therefore, new strategies to increase adherence are necessary first by identifying the reasons behind a prescription, developing an algorithm to help healthcare professionals in the prescribing procedure, and developing innovative devices and formulations that reduce the adherence problems.

In this Special Issue, the aim is to present articles exploring or reviewing the causes of poor adherence and promising solutions in terms of algorithms, devices, or formulations to overcome them. Patient preferences for a device could include different factors, such as device handling, feedback, and remaining doses/end of product indication, as well as the age of the patient and the disease that they have. Moreover, the device/formulation requires being robust to the patient’s use (inspiratory airflow, inhalation technique, hand–mouth coordination, time of delivery, throughout the product use life) as well as the environmental conditions (temperature and humidity).

This Special Issue aims to cover the main aspects of adherence issues via research articles, reviews, as well as communication, opinions, or brief reports from medical and pharmaceutical experts from academia, industry, and healthcare.”

Dr. Nathalie Wauthoz
Prof. Dr. Carine De Vriese
Prof. Dr. Francesca Buttini
Guest Editors

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Keywords

  • adherence
  • healthcare
  • device
  • dry powder for inhalation
  • pressurized metered device for inhalation
  • dry powder inhaler
  • inhalation technique
  • algorithm
  • device handling
  • feedback

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Published Papers (2 papers)

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17 pages, 667 KiB  
Article
Asthma and COPD: Comparison with International Guidelines and Medication Adherence in Belgium
by Natacha Biset, Mélanie Lelubre, Stéphanie Pochet and Carine De Vriese
Pharmaceuticals 2023, 16(7), 1030; https://doi.org/10.3390/ph16071030 - 20 Jul 2023
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Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are major chronic conditions. It is possible to limit their impact by controlling symptoms, which limits exacerbations and worsening of the disease, by choosing the appropriate treatment and ensuring that the patient adheres to it. The [...] Read more.
Asthma and chronic obstructive pulmonary disease (COPD) are major chronic conditions. It is possible to limit their impact by controlling symptoms, which limits exacerbations and worsening of the disease, by choosing the appropriate treatment and ensuring that the patient adheres to it. The main purpose of this study was to assess medication adherence and persistence with inhaled medications for chronic treatment of asthma and COPD, as well as to evaluate the factors influencing this adherence. Medication adherence was measured from January 2013 to December 2016 using continuous multiple-interval measures of medication availability (CMA). Persistence was evaluated by treatment episodes (TE). We analyzed the influence of different factors on CMA such as sex, age, type of device, and the realization of the “new medicines service” (NMS), introduced in Belgium in October 2013 to support patients in adhering to their treatment. We also analyzed the consumption of these inhaled medications within the Belgian population and compared them with the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. Medication adherence varied greatly between the different pharmacological classes: inhaled corticosteroids (ICS) alone or in combination with long-acting beta agonists (LABA) had the lowest medication adherence and persistence, while adherence was highest for the long-acting muscarinic antagonists (LAMA) and LABA/LAMA associations. The NMS seemed to have a positive impact on medication adherence, although few patients completed the two guidance interviews offered by the service. In addition, only a minority of the targeted patients took advantage of this new service. Full article
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25 pages, 3880 KiB  
Systematic Review
Clinical Impact of Electronic Monitoring Devices of Inhalers in Adults with Asthma or COPD: A Systematic Review and Meta-Analysis
by Noe Garin, Borja Zarate-Tamames, Laura Gras-Martin, Raimon Milà, Astrid Crespo-Lessmann, Elena Curto, Marta Hernandez, Conxita Mestres and Vicente Plaza
Pharmaceuticals 2023, 16(3), 414; https://doi.org/10.3390/ph16030414 - 8 Mar 2023
Cited by 5 | Viewed by 4657
Abstract
We conducted a systematic review and meta-analysis to gain insight into the characteristics and clinical impact of electronic monitoring devices of inhalers (EMDs) and their clinical interventions in adult patients with asthma or COPD. The search included PubMed, Web of Science, Cochrane, Scopus [...] Read more.
We conducted a systematic review and meta-analysis to gain insight into the characteristics and clinical impact of electronic monitoring devices of inhalers (EMDs) and their clinical interventions in adult patients with asthma or COPD. The search included PubMed, Web of Science, Cochrane, Scopus and Embase databases, as well as official EMDs websites. We found eight observational studies and ten clinical trials, assessing a wide range of clinical outcomes. Results from the meta-analysis on adherence to inhalers in a period over three months were favourable in the EMD group (fixed effects model: SMD: 0.36 [0.25–0.48]; random effects model SMD: 0.41 [0.22–0.60]). An exploratory meta-analysis found an improvement in ACT score (fixed effect model SMD: 0.25 [0.11–0.39]; random effects model: SMD: 0.47 [−0.14–1.08]). Other clinical outcomes showed mixed results in the descriptive analyses. The findings of this review highlight the benefits of EMDs in the optimization of adherence to inhaled therapy as well as the potential interest in other clinical outcomes. Full article
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