Photo Credit: Streetoncamara
Chronic obstructive pulmonary disease (COPD) continues to pose significant challenges for both patients and healthcare professionals, requiring a multifaceted approach to management.
Several clinicians recently weighed in on the latest strategies to optimize care, emphasizing the importance of addressing inhaler adherence, exploring new assessments, and incorporating novel technologies.
Inhaler Adherence
“Due to their drug expertise, pharmacists can aid in optimizing drug therapy and be instrumental in medical management via screening for potential drug-drug interactions and contraindications, identifying possible adverse drug events, and making clinical recommendations to individualize patient therapy and adjustments to treatments and dosing when warranted to improve adherence rates and long-term clinical outcomes. In addition to complex drug regimens, improper inhaler techniques can affect outcomes in patients with COPD. Pharmacists can be instrumental in educating patients about proper inhaler techniques and routinely assess patient techniques to ensure the correct delivery of prescribed therapy.
“A recent study revealed that an estimated 69% of patients hospitalized with COPD used inhaler devices incorrectly, with 66% of patients making critical errors during inhaler use, which meaningfully impacted the effectiveness of the medication and the patient’s response to therapy. The findings also highlight the disease and treatment burdens encountered by patients with COPD and the need to expand awareness among clinicians about identifying and addressing treatment challenges including proper inhaler technique to manage COPD effectively.”
— Yvette Terrie, RPh, BS Pharm, Consultant Pharmacist
An Alternative to Manovacuometers
“The one-repetition maximum test method of assessing PIMax [maximal inspiratory mouth pressure] in people with COPD appears to generate similar results to those directly evaluated by a manovacuometer (the gold standard method for this measurement).
“IMT using threshold devices improves inspiratory muscle strength, exercise capacity, and QOL while decreasing dyspnea. That is the conclusion of one of the most up-to-date meta-analyses regarding IMT and COPD. However, IMT is not often implemented in physiotherapy practice. We believe that this study helps to overcome one of the main barriers to implementing IMT: the high costs of manovacuometers (usually higher than the monthly salary of a physiotherapist). Thanks to a quick, simple, inexpensive, and accessible PIMax assessment protocol such as the one validated in this study, we believe that implementing this training modality could now be expanded.”
— Raúl Fabero-Garrido, MSc, Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid
Mind-Body Exercise
“Our meta-analysis revealed that mind-body exercises, such as Tai Chi and yoga, significantly improve lung function indicators (FEV1, FEV1/FVC, FEV1%) and exercise capacity as measured by the Six-Minute Walk Test (6MWT) in stable patients with COPD. These findings suggest that integrating mind-body exercises into comprehensive rehabilitation programs could benefit these patients.
“Physicians can recommend mind-body exercises as part of a holistic treatment plan for patients with COPD. By incorporating these gentle exercises, which are adaptable to various environments, into standard care, physicians can offer patients an additional tool to improve their respiratory function and overall well-being.”
— Feng Zhai, MD, College of Physical Education, China University of Mining and Technology
Artificial Intelligence
“AI can be integrated into telemonitoring systems for COPD to detect patterns used to identify signs of exacerbations or infections earlier than what a clinician might detect. AI can then provide feedback to the person with COPD in response to telemonitoring findings about redirecting the patient away from exacerbation or identifying the triggers that may be responsible for exacerbation.
“Teaching patients about managing their COPD can be difficult because there are so many factors to account for. AI can be a guide that is always available where they can ask questions and get answers to help them best manage their condition. But it can also provide real-time feedback on their training, show their progress, and progress their programs as the patient demonstrates the ability to complete parts of training without clinician intervention.”
— Kaelee Brockway, PT, DPT, EdD, University of St. Augustine for Health Sciences
