Therapeutic compliance in elderly patients with COPD

F. Pagano

University Polyclinic Agostino Gemelli, Rome, Italy

The problems of therapeutic adherence are very frequent in the elderly. Compliance to drug therapy in COPD is much lower than that of other common diseases such as diabetes, osteoporosis, hypertension. Major predictors of poor adherence to medication are presence of psychological problems, presence of cognitive impairment, treatment of asymptomatic disease, inadequate follow-up or discharge planning, side effects of medication, patient’s lack of belief in benefit of treatment, patient’s lack of insight into the illness, poor provider-patient relationship, presence of barriers to care or medications, missed appointment, complexity of treatment, cost of medication, copayment or both.

Number of daily administration and rapid onset of the effect of the drugs may affect compliance with therapy.

Comorbidity can affect adherence to therapy because more factors may interfere with drugs assumption (mental impairment, depression, visual impairment, functional limitations related to arthritis, cerebrovascular disease, parkinsonism).

Polypharmacy can also adversely affect compliance.

Another factor that significatively influences therapeutic compliance is the devices management.

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