The importance of therapy adherence for patients with lung diseases
Adherence to therapy has proven to be very difficult for patients with lung diseases. Adherence to therapy translates to correct inhalation technique and timely use of the inhaler. COPD patients who do not use their medication as prescribed are hospitalised more often, have a lower quality of life and a reduced life expectancy. This emphasises the great importance of therapy adherence. The reason for non-compliance varies from patient to patient and has many underlying causes. Think of forgetfulness, difficulties in taking the medication or a fear for high costs. Therefore, a personal approach is crucial to improve therapy adherence. The digital spacer is an excellent example of this.
From ‘one size fits all’ to a personal instruction
Job van Boven, founder of MAECON, about the study: “As a practitioner, you see your patients twice a year, for example. We then give a 'one size fits all' instruction on how to use the inhaler. Afterwards, the patient goes home and we hope that the patient uses the medication correctly. In practice, we see that 70 percent of the patients don’t have a correct inhalation technique. Thus, a smart solution to help people improve their technique is very welcome.”
The digital spacer measures each inhalation, checks the quality of the inhalation and provides personal feedback to patients about their medication use in the past month(s). The digital spacer provides a complete picture of the patient's medication use. With this data, personalised instructions can be given to prevent inhalation faults. These personalised instructions have proven to be successful: 38 percent of the patients had less inhalation faults. It is currently being examined whether this has also led to a better medicine exposure in scalp hair.
A long-term study is needed to further investigate the effect of the digital spacer on other outcomes, such as hospital admissions.
Combing data with personal instructions
In this study the patient’s personal medication intake data were combined with a practical tool for practitioners to improve therapy adherence. With this tool, a therapy adherence wheel, it is possible to discover a patient’s personal challenge in taking medication as prescribed, together with the patient. Afterwards, the wheel gives therapy intervention strategies to help therapy adherence. “The combination of digital data and personal feedback creates a step forward to optimal medication use,” mentions Van Boven.
Second study with the digital spacer started
The second study with the digital spacer started this week with asthma patients. Van Boven: “In this randomised study we educate half of the patients with personalised instructions, the other half receives a general instruction. This way we can measure the difference between these groups.” The results of this study are expected halfway 2022.
This study was executed by a multidisciplinary regional team consisting of a general practitioner promovendus, a lung specialist, a technologist from the University of Groningen and pharmacists of the UMCG and the Martini Hospital.