171 The patients’ view of nebulised drugs: knowledge, adherence, and difficulties

Miles, Karen E.; Lenaghan, S.; Blanch, L.; Doe, S.; Bourke, Stephen; Caraher, M.; Anderson, A.

doi:10.1016/s1569-1993(14)60307-6

Cited by 1 publication

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“…Patients are constantly making their own judgments about balancing the benefits of treatment against the burden imposed, and clinicians frequently make assumptions as to reasons why adherence is variable. In a structured interview study evaluating the patient’s perspective of nebulised therapies [ 41 ] most patients knew their correct prescription and the purpose of the drug. They reported variable adherence to their individualised regimens with the top reasons listed as: patient choice (17%), treatment burden (15%), time (15%), adverse effects (11%), and perception of benefit (9%), although actual adherence rates were not reported in this study.…”

Section: Treatment Regimens and Adherencementioning

confidence: 99%

Inhaled therapy in cystic fibrosis: agents, devices and regimens

Agent

Parrott

2015

Breathe

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Key pointsThere have been significant advances in both inhalation medicines and delivery devices with “intelligent nebulisers” and “dry-powder inhalers” becoming commonplace in CF care.Inhaled medicines generate high levels of a drug within the airways with limited systemic effects, offering safe and convenient antibiotic and mucolytic therapy for individuals with CF.Variations in adherence are not unique to CF; however, treatment burden is high and therefore fast inhaled drug delivery devices may assist individuals in completing the prescribed treatment regimes.Prescribers of inhaled medicines have a responsibility to consider, in addition to efficacy, the appropriated drug/device combination for each individual in order to promote adherence and achieve the desired clinical benefit.SummaryThe recognised mainstay daily treatments for cystic fibrosis (CF) focus on inhaled and oral medications, airway clearance and optimised nutrition. This review discusses recent advances in inhaled therapies for the management of CF, including devices such as intelligent nebulisers, drug formulations and supporting evidence for inhaled antibiotics (for the management of chronic Pseudomonas aeruginosa) and muco-active drugs. We include practical advice for clinicians regarding the optimisation of inhalation technique and education. The influence of adherence on the use of inhaled therapies in CF is also reviewed.Educational aimsTo inform readers about the history and progression of inhaled therapies for people with CF with reference to the literature supporting current practice.To highlight the factors that may impact the success of inhaled therapies, including those which are device specific such as drug deposition and those which influence adherence.

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Section: Treatment Regimens and Adherencementioning

confidence: 99%