Effects of individualized inhaler education on medication adherence and disease control for COPD and asthma patients

McKenzie Nicole Nuss

Background: As of March 18, 2022, there were 37 million people in the United States living with a chronic pulmonary disease (American Lung Association, 2022). Pulmonary diagnoses are routinely managed with prescription inhaled medications, yet studies have shown that 50-80% of pulmonary patients do not adhere to their prescribed regimen (Gregoriano et al., 2018). Inappropriate use of an inhaler is one of the most widely reported barriers to medication adherence (Sánchez-Nieto et al., 2022). Patients report forgetting to use an inhaler and lacking the knowledge about the dosing and frequency of their inhalers as reasons for their nonadherence (Sánchez-Nieto et al., 2022). When patients are not adherent to their prescribed regimens, they are at an increased risk of having poor disease control (Lindsay & Heaney, 2013). Purpose: This project’s purpose was to evaluate the effects of providing individualized inhaler education to patients with COPD and/or asthma on their medication adherence and disease control. Methods: This prospective cohort project was implemented using the Iowa Model framework. A nonexperimental comparative design was utilized to assess the impact of an intervention on participant disease control and medication adherence. The population consisted of patients aged 18 years and older with at least one pulmonary diagnosis. Findings: Most participants reported that they were adherent to their medication regimen (n = 86, 93%), and most asthma control test (ACT) scores increased at follow-up (67%). The post-intervention FEV1 was significantly higher than the pre-intervention FEV1 with p <.001. All stages of chronic obstructive pulmonary disease revealed improved post-intervention FEV1s. Insurance was found to be a barrier to medication adherence. Discussion: Providing inhaler education leads to high rates of medication adherence and better disease control among patients with obstructive pulmonary disease. On average, ACT scores and FEV1s were improved at follow-up. Results were clinically significant. References American Lung Association. (2022). Our impact. Retrieved September 4, 2022 from https://www.lung.org/about-us/our-impact Gregoriano, C., Dieterle, T., Breitenstein, A. L., Dürr, S., Baum, A., Maier, S., Arnet, I., Hersberger, K. E., & Leuppi, J. D. (2018, Dec 3). Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respir Res, 19(1), 237. https://doi.org/10.1186/s12931-018-0936-3 Lindsay, J. T., & Heaney, L. G. (2013). Nonadherence in difficult asthma - facts, myths, and a time to act. Patient Prefer Adherence, 7, 329-336. https://doi.org/10.2147/ppa.S38208 Sánchez-Nieto, J. M., Bernabeu-Mora, R., Fernández-Muñoz, I., Carrillo-Alcaraz, A., Alcántara-Fructuoso, J., Fernández-Alvarez, J., Vera-Olmos, J. C., Martínez-Ferre, M. J., Olea, M. G., Valenciano, M. J. C., & Martínez, D. S. (2022, Jan 10). Effectiveness of individualized inhaler technique training on low adherence (LowAd) in ambulatory patients with COPD and asthma. NPJ Prim Care Respir Med, 32(1), 1. https://doi.org/10.1038/s41533-021-00262-8

Effects of individualized inhaler education on medication adherence and disease control for COPD and asthma patients

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