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March 1, 2019

Integrated Adherence Monitoring for Inhaler Medications

Author Affiliations
  • 1Allergy, Asthma, & Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia
  • 2Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  • 3Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
  • 4Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
JAMA. 2019;321(11):1045-1046. doi:10.1001/jama.2019.1289

Many adults, particularly those with chronic diseases, do not take the medications they are prescribed.1 Poor adherence to inhaled controller medications is particularly common among patients with asthma and chronic obstructive pulmonary disease (COPD). Twenty five percent of first prescriptions are not dispensed,2 and for ongoing treatment, adherence, when inhaler use is monitored, averages only between 25% and 50% of the prescribed dose.3,4 Poor inhaler adherence is associated with ineffective symptom control, increased exacerbations, and risk of death. Poor adherence may be intentional, unintentional, or a combination of both; each has different determinants.2 Detecting inadequate adherence is therefore only a starting point, but an indispensable one.

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    1 Comment for this article
    Asthma Sufferer
    Trevor Hart, Physiology, Postgrad LAW | Retired Pharmaceutical Manufacturer
    Patient compliance is not about technology. Simple actions can easily help prescribers monitor usage along with the dispenser. Request for a patient to bring in unused medication at a visit can highlight the "unused and uncollected" medication. This will provide information about over 50% of poor patient compliance and should have been routine 30 years ago. Wasting more money on technology to treat a simple "mindset" problem is wasteful and frankly a "failure to accept responsibility" by the physician and dispenser.
    CONFLICT OF INTEREST: None Reported
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