CHRONIC OBSTRUCTIVE PULMONARY DISEASE: RATE OF THERAPIOTIC ADHERENCE IN OUTPATIENT PRACTICE

Abstract

The adherence of a patient with chronic obstructive pulmonary disease (COPD) to treatment is of utmost importance as it prevents the disease progression and the delayed complication development that determine the quality of life and life span.
 The purpose of the study is to assess the level of adherence for patients with COPD to drug therapy with respiratory drugs, to identify factors influencing the adherence, and study 5-year survival rate based on adherence level.
 Materials and Methods. The study enrolled 150 patients with COPD (87 men, and 63 women, mean age 58.3±0.86 years). Pulmonary function (FEV1, FVC, FEV1/FVC), severity of respiratory symptoms (mMRS scale, CAT questionnaire), and disease severity were assessed (GOLD, 2022). Adherence to COPD treatment was determined according to the Morisky-Green test (1986). Five-year survival rate of patients was analyzed.
 Results. Low adherence to treatment in patients with COPD was revealed: 1 month after the initiation or correction of respiratory therapy, only 32 patients (21.3 %) were assessed as adherent, 56 patients (37.3 %) were insufficiently adherent, and 62 patients (41.3 %) were non-adherent to treatment. Adherence to treatment was associated with age, disease severity, severity of respiratory symptoms, FEV1 and did not depend on gender. In five years, survival rate in the group of non-adherent patients (89.5 %) and insufficiently adherent patients (80.4 %) was significantly higher than in the group of adherent one (61.9 %). It is associated with a more severe status of patients who are adherent to therapy.
 Conclusion. The authors identified an insufficient adherence level in patients with COPD. Elderly patients with a more severe course of the disease, low FEV1 levels, and severe exacerbations are more adherent to respiratory drug therapy. Worse five-year survival rates were observed in the group of patients who were adherent to therapy. It was associated with more severe clinical status, age and comorbidity.