Patientenpräferenz von Inhalern

Zusammenfassung

Standbein der Medikamentenapplikation bei Asthma und COPD ist die Inhalation. Der Vorteil ist die Therapie direkt am Ort des Geschehens. Allerdings steigt durch die Fülle an immer wieder neuen auf dem Markt angebotenen Inhalern eher die Verwirrung, als dass diese als Möglichkeit einer differenzierten Applikationsform wahrgenommen werden. Die korrekte, Patienten-bezogene Verschreibung des richtigen Inhalers wird für den verschreibenden Arzt und den Anwender zu einer schwierigen und nur schwerlösbaren Aufgabe. Der Aspekt der korrekten für den Patienten passenden Inhalerauswahl wird in Asthma- und COPD-Leitlinien kaum oder gar nicht berücksichtigt, obwohl bekannt ist, dass eine komplizierte Inhalertechnik, eine fehlende oder unzureichende Einweisung, Fehler bei der Anwendung und die fehlende Berücksichtigung der Patientenbedürfnisse zu einer ineffektiven Medikamentenapplikation, einer schlechten Patientenadhärenz und damit zu einer unzureichenden Kontrolle der zu therapierenden obstruktiven Atemwegserkrankung führen. Es wird hier eine Übersicht über die wichtigsten Inhalertypen gegeben und die Beziehung zwischen der Patientenakzeptanz auf der einen und der Fehlerhäufigkeit auf der anderen Seite erläutert. Grundsätzlich gilt, je besser der Patient seinen Inhaler akzeptiert und in der Folge auch mit seiner Technik zurechtkommt, desto besser ist der Therapieerfolg.

Abstract

The cornerstone of drug application in obstructive pulmonary diseases is by inhalation as advocated by all treatment guidelines. Today, there exists an extensive choice of inhalers and new models. Numerous inhaler types are constantly being developed and introduced into the market making the “correct” selection a wearying task for the physician as well as for the patient. Improvement in the management of this aspect, which is often neglected in its importance in daily practice as well as in guidelines, is therefore reliant not only on the medications themselves but also on their effective delivery. Complicated inhaler mechanics and poor inhaler technique which do not meet the patient requirements and desires contribute to poor compliance eventually leading to poor disease control. In this review, the importance of inhaler acceptance and the degree of satisfaction with different inhaler types are discussed. This paper focuses on the behavioral and attitudinal evidence that the acceptance of the inhaler is linked to patient compliance, and its linkage on health and patient-reported outcomes.

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