Compliance with Inhalation Therapy in the Digital Age

U svakodnevnoj primjeni, suradljivost s inhalacijskom terapijom je između 10 % i 70 %. Nenamjerna nesuradljivost se odnosi na bolesnike koji nisu donijeli odluku o smanjivanju ili prestanku uzimanja terapije, ali svejedno dolazi do neredovitosti i neadekvatnosti primjene preporučenoga lijeka. Jedan oblik nenamjerne nesuradljivosti – nesvjesna nenamjerna suradljivost – koji je inherentan inhalacijskoj terapiji, teže je otkriti. Često je uzrok neadekvatnog terapijskog uspjeha i pogoršanja kontrole bolesti pa i potrebe za hitnim intervencijama i bolničkim liječenjem. Do nje dolazi zbog nepravilne uporabe inhalera. Ta vrsta nesuradljivosti se nalazi u do 40 % bolesnika i teže se otkriva jer bolesnik misli da redovito uzima lijek. Aktualne smjernice inzistiraju na redovitoj provjeri inhalacijske tehnike i nalaženju najprimjerenijeg tipa inhalera za pojedinog bolesnika uz provjeru načina njegove primjene. S vremenom uporabe zna doći do pogoršanja inhalacijske tehnike pa tako i bolesnici koji dulje vrijeme uzimaju isti lijek putem istog inhalera znaju početi griješiti i na koncu neadekvatno uzimati lijek. Laka dostupnost informacija na webu ili putem mobilnih aplikacija omogućuje njihovu uporabu u cilju edukacije bolesnika. Takav način edukacije se pokazao pristupačan bolesniku, omogućuje mu dodatnu edukaciju u kućnim uvjetima i u trenutku koji bolesnik sam odabere te smanjuje rizik pogoršanja bolesti. Razvijeni su senzori koji prate protok zraka pri aktivaciji inhalera ili analiziraju zvučne fenomene pri inhalaciji i prema njima određuju kvalitetu udaha. Takvi uređaji putem bežične veze mogu prebaciti podatke o kvaliteti inhalacije na mobilni uređaj bolesnika koji na taj način, u realnom vremenu, dobiva informaciju o pravilnosti uzimanja terapije, što omogućuje ispravak vremena i načina doziranja lijeka.In terms of daily usage, compliance with inhalation therapy is between 10% and 70%. Unintentional non-compliance refers to patients who have not decided to reduce or discontinue therapy, but there is still irregularity or inadequacy of the recommended drug. One form of unintentional non-compliance is more difficult to detect: unconscious unintentional non-compliance, essential for inhalation therapy. It is often the reason for inadequate therapeutic success and deterioration of control of the disorder, or even calls for emergency interventions and hospital treatment, all because of improper inhaler use. This type of non-compliance is found in up to 40% of patients and is more difficult to detect because the patient believes he is taking the medication regularly. Current guidelines insist on regular routine checks of inhalation technique and finding the most adequate type of inhaler per patient, as well as checking the usage method. Over time, inhalation techniques can fall back, so patients who use the same inhaler and same medicine for a prolonged period of time may start to err and end up taking it improperly. Quick access to information on the web or via mobile apps enables ease of use for patient education. Such a model has proven to be user-friendly for the patient, allowing for additional education in the patient’s own home environment, at whatever time they choose, and reduces the risk of exacerbation. Sensors monitoring airflow upon inhaler activation have been developed, which also act to analyze sound phenomena during inhalation to determine the quality of the breath. Such apparatuses can wirelessly transfer data on the quality of inhalation to the patient’s mobile phone, thus enabling real-time dispatch of information on the correctness of therapy usage, and as a consequence, rectify time intervals and dosage method