Why focus on comorbidities?

How many of your COPD patients also suffer from other comorbid conditions? It can be helpful to keep these conditions in mind when choosing appropriate treatment for COPD patients. This is especially true when the use of a treatment’s delivery system may be impacted by a patient’s conditions, including those that limit coordination and dexterity.1,2*

Have you ever heard the following common “myth-conception” about comorbid conditions in COPD patients?


*

The impact of comorbid conditions and device choice on clinical outcomes has not been demonstrated.

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Can comorbid conditions have an effect on inhaler use?

myth

“Comorbidities never play a significant role in patients’ ability to use their inhaler correctly.”

fact

Considerations for the correct use of an inhaler device in older COPD patients2*

  • Cognitive function
  • Tremors
  • Hand–eye coordination
  • Dexterity and hand strength
  • Vision
  • Hearing

In a study published in the American Journal of Respiratory and Critical Care Medicine,† 94% of patients with severe COPD did not use their inhaler regularly and correctly most of the time during the month following hospital discharge.3

Inhaled therapy should be individualized for patients with COPD, with selection influenced by their cognitive, physical, and educational abilities.1,2


*

The impact of comorbid conditions and device choice on clinical outcomes has not been demonstrated.


†

A prospective observational study in which 244 patients with COPD were given a maintenance inhaler with an attached electronic recording device (INCA) at hospital discharge. Mean patient age was 71 years, mean FEV₁ was 1.3 L, and 55% of patients had evidence of mild/moderate cognitive impairment.3

Learn more about HHI technique errors

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How common are comorbid conditions?

myth

“Comorbid conditions in COPD patients are not that common.”

fact

Comorbid conditions may be more common than you think. In separate studies:

  • approximately 1 in 5 patients with advanced COPD and ≥60 years of age had impaired inspiratory effort4
  • over half of COPD patients ≥45 years of age were likely tohave coexisting arthritis5
  • up to 1 in 3 COPD patients had either borderline or impaired cognitive function3,6,7*
*

Results of tests measuring psychomotor speed and executive control function.

See why continued reassessment matters

References: 1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2021 Report). https://goldcopd.org/2021-gold-reports/. Accessed December 3, 2020. 2. Lavorini F, Mannini C, Chellini E, et al. Optimising inhaled pharmacotherapy for elderly patients with chronic obstructive pulmonary disease: the importance of delivery devices. Drugs Aging. 2016;33(7):461-473. 3. Sulaiman I, Cushen B, Greene G, et al. Objective assessment of adherence to inhalers by patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;195(10):1333-1343. 4. Mahler DA, Waterman LA, Gifford AH. J Aerosol Med Pulm Drug Deliv. 2013;26(3):174-179. 5. Schnell K, Weiss CO, Lee T, et al. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999-2008. BMC Pulm Med. 2012;12:26. 6. Schure MB, Borson S, Nguyen HQ, et al. Associations of cognition with physical functioning and health-related quality of life among COPD patients. Respir Med. 2016;114:46-52. 7. Baird C, Lovell J, Johnson M, et al. The impact of cognitive impairment on self-management in chronic obstructive pulmonary disease: a systematic review. Respir Med. 2017;129:130-139.


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