Patients with asthma present with a long list of management problems for any physician, including the pulmonary specialist. One of the biggest problems that we have to wrestle with is something called non-compliance. Non-compliance occurs when a patient does not adhere to the instructions or medication given for his or her problem, in this case asthma. The reason for the non-compliance varies from lack of understanding the instructions or the reasons or effects of the medications being used, to inability to pay for the treatment. Unfortunately, many patients will continue to complain of symptoms, but not reveal their non-compliance. The physician in these circumstances assumes the patient needs more aggressive treatment.
A recent study used a complicated home compliance technique for asthma patients that used daily questionnaires, measurements of expired nitric oxide (a marker for inflammation) and the monitoring of inhaler use. Of the 250 patients in the original study, 20% were unable to complete the gas analysis, only 41 patients used their inhaler properly, and 12 patients had an adherence rate of less than 70%.
Think of the time and money invested in trying to get these patients to follow instructions and prevent the needless advancement of their therapy. Here is my request to any of you taking medications for lung problems or any other, if you are having problems with your medications for whatever reason, or if you are simply not taking them, tell us. We want to know and we want to help.
