Bronchial asthma: focus on adherence to inhaled therapy

Abstract

The rising incidence of the disease, severe exacerbations, and risks of death make bronchial asthma an urgent public health problem. Effective control of the disease is recognised as the main goal of modern therapy. Studies conducted in our country and abroad show a low level of bronchial asthma control in most patients. An important condition for achieving control is the patient’s adherence to therapy. Higher adherence rates and, consequently, improved quality of life have been recorded in patients receiving baseline therapy, which involves a single inhalation per day. The long-acting combination powder inhaler fluticasone furoate/ vilanterol is one of the modern drugs with proven efficacy and safety. The drug has been shown to significantly improve lung function and reduce the frequency of asthma exacerbations. Of particular note are the results of a randomised clinical trial carried out in real (everyday) clinical practice. This form of study is non-selective, i.e. it includes a wide group of patients regardless of severity, comorbidities and lifestyle. This approach was used in a study called the Salford Lung Study. It included patients with bronchial asthma who were receiving ongoing maintenance therapy with inhaled glucocorticosteroids or combinations thereof from primary care centres. The study lasted for 52 weeks. The first group consisted of patients treated with the fluticasone furoate/vilanterol combination. Group 2 patients continued to receive baseline therapy. The best response was observed with the fluticasone furoate/vilanterol combination. It was maintained in all subgroups analyzed and was independent of smoking status, baseline control reduction, and number of severe exacerbations in the past year. Adherence to treatment is improved by a single dose and a convenient, intuitive means of delivery. The inhaler requires minimal coordination, is activated with a single movement and has an easy-to-understand dose counter.