Why focus on reassessment?

Proactive reassessment of COPD patients is an important way to evaluate their response to therapy and keep track of other changes in their condition.1 Changes in patients’ hand–breath coordination and/or physical and cognitive function along with other factors may impact their ability to use their device correctly.1-3 How often do you reassess your COPD patients?

Check out the following common “myth-conceptions” that can get in the way of timely reassessment of COPD patients.

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Why consider regular reassessment?

myth

“The majority of patients with COPD use their inhalers correctly.”

fact

Many patients make errors when using handheld inhalers (HHIs).4* Aggregate findings across 6 of 10 studies (n=390)† revealed that:

  • 87% of patients made at least 1 inhalation technique error when using metered-dose inhalers (95% CI, 77.5-96.0)4

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, effective management of COPD includes training (including the “teach-back” approach) of proper inhaler technique when selecting a device and reassessment at every visit to determine whether patients are achieving treatment goals.1 The recommended management cycle involves:

  • Review of symptoms (eg, dyspnea) and exacerbations1
  • Assessment of inhaler technique and adherence, and nonpharmacological approaches (including pulmonary rehabilitation and self-management education)1
  • Adjustment of therapy (eg, escalate, switch inhaler device or molecules, de-escalate as necessary)1

Patients should be assessed at every opportunity, especially when experiencing worsening of symptoms.1


*

The relationship between device and clinical outcomes has not been established.


†

55% of patients had a diagnosis of COPD.4

Get more facts about the use of handheld inhalers (HHIs)

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Why check the frequency of rescue inhaler use?

myth

“Overuse (more often than recommended) of rescue inhalers is not a significant issue for many patients with COPD.”

fact

In a study of COPD patients using short-acting rescue inhalers*:

  • nearly half used their device more often than recommended at least once in 3 months5
  • 19% overused their device on more than half of the days they were observed5

Overuse of a rescue inhaler may indicate that the patient’s COPD symptoms are inadequately controlled.5 For example, patients who overused their device in the study had evidence of more severe COPD and were more likely:

  • to be using oxygen therapy5
  • to have increased dyspnea5

Rescue inhaler overuse may also increase the risk of side effects, some of which could be serious.5 Check in with patients at each visit to assess adequate symptom control.1


*

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

Learn about maintenance therapy

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What about reassessing prior to hospital discharge and during follow-up visits?

myth

“As long as patients with COPD are reassessed immediately after a hospitalization, they do not require follow-up reassessments.”

fact

According to the GOLD criteria, it is important to help reduce future risk by:

  • reassessing patients prior to discharge1
  • following up early at 1 month, including review of discharge therapy and a change in treatment if needed1
  • following up at 3 months to review symptoms, lung function, and prognosis1

See the benefits of an individualized approach to therapy

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. Hanania NA, Braman S, Adams SG, et al. The role of inhalation delivery devices in COPD: perspectives of patients and health care providers. Chronic Obstr Pulm Dis. 2018;5(2):111-123. 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. Cho-Reyes S, Celli BR, Dembek C, et al. Inhalation technique errors with metered-dose inhalers among patients with obstructive lung diseases: a systematic review and meta-analysis of U.S. studies. Chronic Obstr Pulm Dis. 2019;6(3):267-280. 5. Fan VS, Gylys-Colwell I, Locke E, et al. Overuse of short-acting beta-agonist bronchodilators in COPD during periods of clinical stability. Respir Med. 2016;116:100-106.


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