Therapieadhärenz bei Asthma bronchiale – Versorgung unter Alltagsbedingungen in der pneumologischen Praxis

Abstract

In the present study, patients with asthma were interviewed with regard to their treatment adherence. It was shown that adherence is significantly influenced by age, occupation, quality of information about the disease and interest of the patient in disease, mode of action and use of the inhalation device. Younger, working patients who do not feel "completely adequately" informed are more likely to be not-adherent. Each aspect should be noted separately.The characterization enables forming target groups for appropriate counselling initiatives in pulmonology practice and allows the effectiveness of the measures to be examined. The results confirm the importance of doctor/patient communication for achieving a high level of adherence and thus therapeutic success.It is suggested that, in addition to questionnaires already in use, asthma patients should be given the following questions in writing during routine monitoring of therapy; based on the results of the survey, the extent of advice necessary can be determined -Do you feel sufficiently informed about your illness? -Do you feel sufficiently informed about the effect of the drug therapy? -Do you feel sufficiently informed about the handling of the inhalation drugs? -Are you satisfied with the handling of your inhalation medication? The following options to answer the questions should be available: completely - mainly - somewhat - not at all. There were significant differences in adherence between patients who were completely satisfied with the handling of their device and those that were not. However, there was no significant difference between the devices. Therefore, the same therapy adherence can be predicted for all devices when the device is suitable for the patient and also provides complete satisfaction in handling. Since it is the subjective perception of patients, the data show significant differences between study centres. These were mirrored in a blind benchmark to stimulate improvements.

From board to bedside – training the communication competences of medical students with role plays

“…A recent study on whether patients with chronic bronchial asthma adhered to treatment also showed that adherence was significantly related to the quality of the information given to the patient. Nevertheless, the authors showed that in patients’ daily routines, only about 55% indicated feeling “totally sufficiently” informed about their medications’ mechanism of action [8]. Effective communication training methods for doctors-to-be are therefore needed.…”

Reduktion klimaschädlicher Treibhausgase durch Auswahl der Inhalatoren in der Therapie von Patienten mit Asthma und COPD

“…Intensive Unterweisung im Gebrauch der Inhalatoren und Patientenschulung zu besserem Krankheitsverständnis tragen zusätzlich wesentlich zur Stabilität der Patienten bei [28]. Bei Wechsel des Inhalationssystems besteht zur Erzielung einer guten Adhärenz vor allem bei Patienten unter 50 Jahren, Berufstätigen und Patienten, die generell zu ihrer Erkrankung und der Wirkungsweise der Medikamente subjektiv zu wenig informiert sind, ein hoher Gesprächsbedarf [29]. Es ist zu empfehlen, mittels aut idem-Kennzeichnung die Abgabe desjenigen Inhalators durchzusetzen, auf den der Patient geschult ist, mit dem nach Lungenfunktion und Handhabung die beste Deposition zu erreichen ist, der eine gute Adhärenz erwarten lässt und der die geringste Treibhausgaswirkung entfaltet [30].…”