Related Experiment Video
Updated: Apr 16, 2026

Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System
Published on: April 6, 2017
Differences in Adherence to Common Inhaled Medications in COPD
Kirsten Koehorst-ter Huurne1, Kris Movig2, Paul van der Valk1
1a Department of Pulmonary Medicine , Medisch Spectrum Twente , Enschede , the Netherlands.
Objective:
To study differences in adherence to common inhaled medications in COPD.
Methods:
Adherence of 795 patients was recorded from pharmacy records over 3 years in the COMIC cohort. It was expressed as percentage and deemed good at ≥75-≤125%, sub-optimal ≥50-<75%, and poor <50% (underuse) or >125% (overuse). Most patients used more than one medication, so we present 1379 medication periods.
Results:
The percentages of patients with good therapy adherence ranged from 43.2 (beclomethasone) -75.8% (tiotropium); suboptimal from 2.3 (budesonide) -23.3% (fluticasone); underuse from 4.4 (formoterol/budesonide) -18.2% (beclomethasone); and overuse from 5.1 (salmeterol) -38.6% (budesonide). Patients using fluticasone or salmeterol/fluticasone have a 2.3 and 2.0-fold increased risk of suboptimal versus good adherence compared to tiotropium. Patients using salmeterol/fluticasone or beclomethasone have a 2.3- and 4.6-fold increased risk of underuse versus good adherence compared to tiotropium. Patients using budesonide, salmeterol/fluticasone, formoterol/budesonide, ciclesonide and beclomethasone have an increased risk of overuse versus good adherence compared to tiotropium. Adherence to inhalation medication is inversely related to lung function.
Conclusion:
Therapy adherence to inhalation medication for the treatment of COPD is in our study related to the medication prescribed. Tiotropium showed the highest percentage of patients with good adherence, followed by ciclesonide, both dosed once daily. The idea of improving adherence by using combined preparations cannot be confirmed in this study. Further research is needed to investigate the possibilities of improving adherence by changing inhalation medication.
More Related Videos
Related Concept Videos
Inhaled Medications
Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
COPD: Management Using Bronchodilators and Corticosteroids
Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment

