Strategies to improve adherence to inhaled therapies in asthma and COPD

Respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) are significant public health problems. Despite the fact that effective treatments are available to help improve symptoms and reduce disease exacerbations, asthma deaths are continuing to rise in the UK and COPD is now the third-leading cause of death worldwide (GOLD, 2024; Levy et al, 2024). This represents a clear disconnect between the success of treatments in the clinical trial setting, and effective disease management in real-world situations.

As with any long-term health condition, the success of treatment relies on patient adherence, defined as the extent to which a patient acts in accordance with the prescribed interval and dosing regime (Cramer et al, 2008). Medication-taking is a complex behaviour, leading to approximately 50% of patients with chronic conditions exhibiting non-adherence (Brown and Bussell, 2011). This rate may be even higher in respiratory disease, with a recent study indicating non-adherence in 40% of patients with asthma and 30% of patients with COPD (Unni et al, 2021).