Adhärenz beim Alterspatienten mit COPD/Asthma

Zusammenfassung

Zielsetzung: Die globale Prävalenz von COPD steigt mit fortschreitendem Alter weiter an. Um gravierende Krankheitsverläufe zu verzögern, ist neben der Verfügbarkeit von Therapien auch die Therapietreue der Patienten von hoher Bedeutung. Diese hängt bei Patienten mit COPD wesentlich von der Handhabung des Inhalers ab. Die vorliegende Untersuchung soll folgende Fragestellung beantworten: Besteht in der Subgruppe der älteren Patienten die Notwendigkeit für einen intuitiven Inhaler, um die Therapietreue und damit die Symptomkontrolle zu verbessern?

Methodik: Es wurde eine systematische Recherche mit den Suchbegriffen „adherence/compliance“ in Kombination mit „Asthma/COPD“ und „Device/Inhaler“ in den Datenbanken des DIMDI durchgeführt. Die Relevanz der gefundenen Literatur wurde anhand vorher definierter Einschlusskriterien bewertet.

Ergebnisse: Insgesamt konnten 15 Publikationen in die Untersuchung eingeschlossen werden. Alle Publikationen verdeutlichen, dass die Adhärenz bei älteren Patienten mit COPD nicht zufriedenstellend ist. Ursächlich hierfür sind die Handhabbarkeit des Inhalers, kognitive und motorische Fähigkeiten der Patienten und die Kosten des Inhalers.

Schlussfolgerung: In der Gruppe der älteren Patienten mit COPD besteht ein erhöhter Bedarf an intuitiv zu handhabenden Inhalern. Diese würden die Adhärenz der Patienten erhöhen, die Krankheitskontrolle erleichtern und zur Steigerung der Patientenzufriedenheit führen.

Abstract

Aim: The global prevalence of COPD is estimated to be 10 % and increases with age. In order to delay the progression of the disease both adequate care and patients’ adherence are important. In patients with COPD adherence largely depends on the handling of the inhaler. The presented study aims to answer the following question: Is there an increased need for an intuitive inhaler in the subgroup of elderly patients with COPD in order to increase adherence?

Method: A systematic review in the databases of DIMDI with the items “adherence/compliance” in combination with “asthma/COPD” and “device/inhaler” was conducted. Based on defined inclusion criteria the literature was evaluated with regard to its relevance for the topic.

Results: In the study 15 publications were enrolled. All publications point out, that adherence in elderly patients with COPD is not adequate. Reasons for poor adherence are the manageability of the inhaler, cognitive and motor abilities as well as the costs of the inhaler.

Conclusion: There is an increased need for intuitive inhalers in the group of elderly patients with COPD. Thus, adherence could be increased, which leads to both improved disease control and patient satisfaction.

Schlüsselwörter

COPD - Adhärenz - intuitiver Inhaler - systematischer Review

Key words

COPD - adherence - intuitive inhaler - systematic review

• Literatur

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