Respiratory Medication Adherence: Toward a Common Language and a Shared Vision

September–October, 2016Volume 4, Issue 5, Pages 799–801

Eric Van Ganse, MD, PhD, FRCPPress enter key for correspondence informationPress enter key to Email the author

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David Price, FRCGP

Open Access

DOI: http://dx.doi.org/10.1016/j.jaip.2016.04.006

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Article Info

• Abstract
Full TextReferencesThe World Health Organization highlights the importance of optimizing chronic respiratory disease (CRD) medication adherence with a view to improving clinical outcomes and alleviating ever-increasing pressures on the world's health care resources.1, 2 The Global Initiative for Asthma also advocates for optimized adherence, recommending that asthma symptoms and risk be optimized on the lowest dose of therapy appropriate and that high-cost add-on therapies only be considered in patients with severe disease who have persistent symptoms and/or exacerbations despite optimized treatment with high-dose controller medications and treatment of modifiable risk factors.2 This requirement for optimized therapy as a prerequisite to asthma treatment escalations is of increasing relevance as evermore high-cost biological therapies with narrow therapeutic margins are expected to be licensed for CRD. Use of such novel therapies must be targeted at patients with true unmet need to maximize their cost-effectiveness.Yet it is too simplistic to simply call for “good adherence” in all patients across all therapies. Once the benefit-risk ratio of a treatment is shown to be positive, the ultimate goal of the health care professional, payer, and patient should be to achieve “efficient use” of treatment, that is, use that maximizes treatment benefit while minimizing any potential risk of harm....


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