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    The International Society for Aerosols in Medicine

    Richard Dekhuijzen

    Richard Dekhuijzen

    Dr. Richard Dekhuijzen

    Radboud university medical center
    The Netherlands

    Richard Dekhuijzen (Amsterdam, the Netherlands, 1956) is Professor of Pulmonology at the Radboud university medical center in Nijmegen, the Netherlands. His specific areas of clinical and research interest include asthma, COPD and inhalation technology. He is the scientific chair of the Aerosol Drug Management Improvement Team (ADMIT) and chair of the Dutch Inhalation Technology Working Group.

    The Frequency of Non-adherence to Inhaler Therapy and its Impact on Outcomes in Patients with COPD

    Nonadherence to inhaled treatment regimens for chronic obstructive pulmonary disease (COPD) is well known as a clinical problem with a number of important consequences, such as reduced control of the disease, increased health care consumption and increased costs. Nonadherence for COPD is higher than that for many other chronic diseases (70%-80% vs 50%, respectively). There are numerous causes of nonadherence with inhaler use. Intentional factors include ambivalence to treatment, denial of diagnosis, embarrassment about using inhalers in social situations, and concern about adverse events. Unintentional factors include poor inhaler technique (even though the patient thinks he or she is using it correctly), incorrect inhaler use, lack of understanding about when to use an inhaler, forgetfulness, and language barriers. Other factors that can lead to unintentional nonadherence are the need for multiple devices and/or concomitant conditions requiring polypharmacy. Several strategies are effective in increasing adherence. These include careful matching of patient and device, patient empowerment, education and repeated training, and application of electronic monitoring and digital technologies. Ref: Dekhuijzen PNR, Lavorini F, Usmani OS, van Boven JFM. Addressing the impact and unmet needs of nonadherence in asthma and COPD: where do we go from here? J All Clin Immunol Pract 2018; 6: 785-793.