Inhalation systems | Ideal device | Patient Related Requisites | Compliance

Psychosocial and device-related aspects of patient compliance

Studies in adults and children have shown that about 50% of patients are not compliant concerning application of regular treatments. Noncompliance may be defined as the failure of treatment to be taken as agreed upon by the patient and health care professional. Several factors are related with noncompliance like regression of the diagnosis and its severity, communication and beliefs of the patient concerning treatment safety and disease control.

However even if these psychosocial factors are balanced still many patients fail to comply with the treatment due to problems in the correct use of their inhalation devices. Even investigator-independent assessment of inhalation technique with a computerized device revealed problems in using a metered-dose inhaler of 42% concerning inspiratory flow rate, 47% regarding coordination, 24% holding breath at the end of inspiration, and 39% inhaling acceptably deeply.

Several features, which can be implemented in inhalation devices, are thought to rise patient compliance. Feedback mechanisms support the patient concerning correct inhalation manoeuvre thereby improving the user’s technique and compliance. Dose counters will give patient control over number of doses applied and help to reassure, whether daily doses have been taken or not. Many patients, especially on corticosteroid treatment, may be afraid of overdosing. Therefore an overdose prevention mechanism will surely improve compliance with the treatment.


Crompton GK. How to achieve good compliance with inhaled asthma therapy. 2004. Respiratory Medicine; 98 (Suppl.2): S35-S40

Goodman D, Israel E, Rosenberg M, et al. The influence of age, diagnosis, and gender on proper use of metered-dose inhalers. 1994. Am J Crit Care Med; 150: 1256-1261

O´Byrne P. GINA Executive Committee. Global strategy for asthma management and prevention. 2004. National Institutes of Health. Publication No 02-3659

Aspects of improved patient compliance

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