Obstructive Lung Diseases |

Lost in Communication: Discrepancies Between Physician and Patient Reports of Medication-Related Education and Adverse Events in COPD FREE TO VIEW

Kim Lavoie, PhD; Ken Chapman; Deborah Casey, MD; Renata Rea; Katherine Arias; Paul Jones, MD
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University of Quebec at Montreal, Montreal, QC, Canada

Chest. 2015;148(4_MeetingAbstracts):679A. doi:10.1378/chest.2280713
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SESSION TITLE: COPD Poster Discussion

SESSION TYPE: Original Investigation Poster Discussion

PRESENTED ON: Sunday, October 25, 2015 at 01:30 PM - 03:00 PM

PURPOSE: Effective communication between healthcare providers and patients is critical for optimizing adherence and outcomes in COPD. Good patient education and understanding about medication and inhaler technique are important determinants of medication uptake and efficacy. This study assessed the concordance between physician and patient reports of the provision of inhaler education among respirologists and their patients from 5 provinces across Canada.

METHODS: A total of 23 respirologists completed surveys on their usual practice behaviours regarding inhaler education with 210 patients, while 187 of these patients completed similar surveys of their treatment experience regarding inhaler education by their physician. Physicians were in practice for a mean of 20 yrs, and patients who completed surveys were an average of 71 yrs and 52% male. Surveys were completed as part of a larger study assessing gaps between physician and patient perceptions of various aspects of COPD management.

RESULTS: Both physicians and patients reported that patients were prescribed an average of 2.7 inhalers to treat their COPD. 88% of physicians and 89% of patients reported that verbal counselling was the most common method used to provide inhaler education, with 69% of physicians and 77% of patients reporting that physicians provided at least some information about inhaler technique. 89% of physicians reported providing no written information and 65% reported not using a demonstration (placebo) inhaler. Although 61% of physicians said they asked patients to demonstrate their inhaler technique, only 39% of patients concurred; 25% reported that their physicians provided feedback on their technique. 82% of physicians reported following-up on inhaler technique and 54% of patients concurred. While physicians estimated that 37% of their patients experienced adverse events with their inhalers, 51% of patients indicated they experienced side effects.

CONCLUSIONS: Results indicate a low provision of written medication (inhaler) information and conducting inhaler demonstration by physicians. There was also poor concordance between physician and patient reports of physician demonstration of inhaler technique, follow up on inhaler technique, and side effects experienced.

CLINICAL IMPLICATIONS: Strategies to improve physician-patient communication around inhaler education may be warranted to improve adherence and outcomes in COPD.

DISCLOSURE: Kim Lavoie: Grant monies (from industry related sources): Abbvie, Consultant fee, speaker bureau, advisory committee, etc.: Abbvie, Janssen, BI, Novartis, Almirall Ken Chapman: Consultant fee, speaker bureau, advisory committee, etc.: AZ, GSK, Menarini, Roche, Mundipharma, Janssen, Almirall Deborah Casey: Consultant fee, speaker bureau, advisory committee, etc.: Almirall, VitalAire and Boeringer Ingelheim Renata Rea: Employee: Almirall Katherine Arias: Employee: Astra Zeneca Paul Jones: Consultant fee, speaker bureau, advisory committee, etc.: AZ, GSK, Menarini, Roche, Mundipharma, Janssen, Almirall

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