Device dependent compliance of COPD and asthma patients [Device-abhängige therapietreue bei COPD- und asthma-patienten]

Introduction: The global prevalence of COPD is estimated to be 10 % and increases with age. COPD is forecasted to be the third leading cause of death in industrial countries by 2020. In order to delay the progression of the disease both adequate supply and patients' adherence are important. However, drug adherence in chronic diseases is often only about 50 %. The aim of this paper is to determine the importance of adherence in patients with asthma/COPD in the literature. Furthermore, we investigate which factors influence patients' adherence. Material and Methods: We conducted a systematic review in the databases of DIMDI with the items "adherence/compliance"in combination with "asthma/COPD"and "device/inhaler". Based on defined inclusion criteria the literature was evaluated with regard to its relevance for the topic. Results: The study contained 62 publications (mainly original papers). The number of publications increases with decreasing levels of evidence. For the most of the included papers the level of evidence is only III. The results confirm the positive impact of adherence on disease control. Intense and patient specific training, an intuitive handling of the inhaler and electronic monitoring improve treatment adherence. Discussion: We identified multiple factors that have a positive influence on the adherence in patients with asthma/COPD. However, there is still a need for research, especially due to missing long-term data. © Deutscher Ärzte-Verlag.