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Impact-Driven Strategies for Optimizing Inhaled Therapy Adherence in COPD: The OPTIMO Delphi Consensus.

Bernardino Alcázar Navarrete1, María Belén Alonso Ortiz2,3, Esperanza Doña Díaz4

  • 1Department of Medicine, University of Granada, Hospital Universitario Virgen de las Nieves, IBS - Granada, Granada, Spain.

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Summary

Improving medication adherence in chronic obstructive pulmonary disease (COPD) is crucial. Experts recommend simplifying inhaler regimens, using once-daily medications, and empowering patients for better COPD management and outcomes.

Keywords:
Adherence assessment toolsCOPD adherenceDelphi methodInhaled therapy optimizationOnce-daily dosing

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Area of Science:

  • Pulmonary Medicine
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Medication adherence is a significant challenge in managing chronic obstructive pulmonary disease (COPD).
  • Poor adherence negatively impacts symptom control, disease progression, and healthcare utilization in COPD patients.

Purpose of the Study:

  • To establish multidisciplinary expert consensus on practical, prioritized interventions for enhancing medication adherence in stable COPD.
  • To identify strategies that improve both adherence and clinical outcomes in COPD management.

Main Methods:

  • A modified Delphi study involving 73 multidisciplinary COPD management experts.
  • Two rounds of a questionnaire assessing 84 statements on non-adherence, impact, contributing factors, assessment, improvement strategies, and prioritization.
  • Consensus defined as ≥70% agreement on a 9-point Likert scale.

Main Results:

  • Consensus was reached on 74 out of 84 statements.
  • Key interventions identified include simplifying and unifying inhalation regimens, and empowering patients.
  • Digital and automated adherence assessment tools were deemed feasible for routine practice; reducing inhalation frequency with long-acting medications and tailoring device selection were also highlighted.

Conclusions:

  • A practical decalogue for optimizing inhalation therapy in COPD was developed.
  • Expert guidance emphasizes once-daily dosing, simplified devices, and patient engagement as the most effective strategies for improving COPD medication adherence.