[Therapeutic adherence in chronic obstructive pulmonary disease: A literature review]

Abstract

Introduction: In France, only a small number of studies have focused on therapeutic adherence in patients with chronic obstructive pulmonary disease COPD) despite its impact in terms of multimorbidity. The objective of this literature review was a better understanding of adherence as a whole, and the identification of the effects of non-adherence, in order to optimise patient management.

Methods: A search algorithm was developed to identify all publications on therapeutic adherence in COPD published between 2010 and 2017, in English and in French. The databases used were MEDLINE, ScienceDirect, BDSP, Cochrane and CAIRN.

Results: Of the 1551 articles initially identified, 94 were included in the review (65 observational studies, 11 interventional studies and 18 reviews or general overviews). Observational studies considered the predictive factors for adherence/non-adherence, and their consequences. Interventional studies evaluated the efficacy of interventions designed to improve adherence.

Conclusions: Despite major therapeutic progress, the essential problems of COPD management remain. While the treatment armamentarium has expanded in recent years, there is still a great deal of work to be done in simplifying treatment regimens, improving the administration of these treatments and motivating patients to be compliant with them. This review also highlights the need for better physician-patient communication.

Keywords: Adhésion thérapeutique; Bronchopneumopathie chronique obstructive; Burden; COPD; Fardeau; Public health; Santé publique; Therapeutic adherence.