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. 2024 Nov 14:18:2295-2306.
doi: 10.2147/PPA.S467870. eCollection 2024.

Perspectives on Treatment Decisions, Preferences, and Adherence and Long-Term Management in Asthma and COPD: A Qualitative Analysis of Patient, Caregiver, and Healthcare Provider Insights

Miguel Román-Rodríguez  1   2 , Ilona McMullan  3 , Michelle Warner  3 , Christopher H Compton  3 , Ruth Tal-Singer  4 , Jean M Orlow  5 , MeiLan K Han  6
Affiliations

Perspectives on Treatment Decisions, Preferences, and Adherence and Long-Term Management in Asthma and COPD: A Qualitative Analysis of Patient, Caregiver, and Healthcare Provider Insights

Miguel Román-Rodríguez et al. Patient Prefer Adherence. .

Abstract

Purpose: Asthma and chronic obstructive pulmonary disease (COPD) are associated with substantial morbidity and mortality. This analysis assessed patient, caregiver, and healthcare provider (HCP) opinions regarding asthma and COPD diagnosis and treatment, including inhaler device preferences.

Patients and methods: Insights were from: (1) face-to-face/telephone patient/HCP communications with GSK Global Medical Teams; (2) social media listening; (3) a self-completed online patient/caregiver survey. Data were anonymized and informed consent was provided. Qualitative outputs were extracted, analyzed inductively, and coded per key themes, such as treatment preferences (including perceptions of single inhaler triple therapy [SITT] versus multiple inhaler triple therapy [MITT]) and long-term treatment goals. Data could be assigned to ≥1 theme.

Results: Overall, 2966 patient and HCP insights (patients, 1150; HCPs, 1816), 988 social media posts, and 44 survey responses (patients, 33; caregivers, 11) were included. Within this analysis, some patients delayed seeking medical advice due to lack of disease understanding and used alternative information sources to better understand treatment options (eg, social media). Patients preferred SITT over MITT in terms of convenience, ease of use, and perceived efficacy; some believed that MITT provided greater coverage due to frequent dosing. HCPs recognized the tendency of patient preferences to drive treatment decisions, and highlighted a reluctance to change therapy among some patients, particularly those well controlled in current therapy. Patients preferred therapies with a shorter onset of action. Patients tended to measure treatment success by symptom improvement and quality of life, whereas HCPs measured treatment success through clinical tests. HCPs reported a lack of patient awareness of the mortality risk associated with COPD.

Conclusion: There is discordance between patient and HCP perceptions of treatment success and goals in asthma and COPD. Improved patient education and HCP-patient communication are needed to facilitate meaningful shared decision-making, optimize care plans, and provide early treatment options.

Keywords: medical advice; multiple inhaler triple therapy; patient education; quality of life; single inhaler triple therapy; treatment goals.

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Conflict of interest statement

Miguel Román-Rodríguez has received grants for research from GSK and AstraZeneca and fees for lectures and advice from GSK, Boehringer Ingelheim, AstraZeneca, Menarini, FAES, Hebro, Teva, Cipla, Gebro, Chiesi, and Pfizer. Ilona McMullan, Michelle Warner, and Christopher Compton are employees of, and shareholders in, GSK. Ruth Tal-Singer is a retiree and current shareholder of GSK; reports consulting fees from Roche, GSK, COPD Foundation, Italy and Beyond, Renovion, Samay Health, Vocalis Health, AstraZeneca, Immunomet, Teva, and ENA Respiratory; she received share options at ENA Respiratory Pty. Former President and CEO of the COPD Foundation. Jean Orlow has no competing interests. MeiLan K. Han has received personal fees from GSK, AstraZeneca, Boehringer Ingelheim, Cipla, Chiesi, Novartis, Pulmonx, Teva, Verona, Merck, Mylan, Sanofi, DevPro, Aerogen, Polarian, Regeneron, Amgen, Genentech, Apreo Health, RS Biotherapeutics, UpToDate, Altesa Biopharma, Medscape, NACE, MDBriefcase, and Integrity. She has received either in-kind research support or funds paid to the institution from the NIH, Novartis, Sunovion, Nuvaira, Sanofi, AstraZeneca, Boehringer Ingelheim, Gala Therapeutics, Biodesix, the COPD Foundation, and the American Lung Association. She has participated in Data Safety Monitoring Boards for Novartis and Medtronic with funds paid to the institution. She has received stock options from Meissa Vaccines and Altesa Biopharma. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Select verbatim patient and HCP quotes.
See this image and copyright information in PMC

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