Adherencija je, prema definiciji Svjetske zdravstvene organizacije (SZO), „stupanj do kojeg bolesnikovo uzimanje lijekova odgovara propisanom režimu”. Adherencija uključuje bolesnikov pristanak za dogovorene zdravstvene preporuke, što značajno izdvaja adherenciju od compliance (popustljivosti). Ispitivanje adherencije s inhalerima u astmi i KOPB-u pokazalo je poražavajuće rezultate, tako da značajno manje od polovine bolesnika koristi preporučeni inhaler za temeljno liječenje astme ili KOPB-a redovito tijekom godine dana. S druge strane, dio bolesnika koristi prečesto brzodjelujući bronhodilatator za olakšavanje tegoba (SABA), čime ne pridonose kvalitetnom liječenju, već lošijoj kontroli bolesti i češćim egzacerbacijama astme. Također, bolesnici s astmom mogu se potpuno prikloniti preventivnom liječenju kada imaju simptome, ali postaju slabo adherentni kada su stabilno i dobro. Poželjno je da osoba s astmom ili KOPB-om i njegov liječnik zajedno pronađu cilj liječenja. Motivacijski razgovor u kojem postoji pokazivanje pozitivnih emocija od strane liječnika, empatija, aktivno slušanje s poticanjem pitanja te davanje jasnih odgovora, ohrabrivanje i slavljenje malih uspjeha, kao i sažimanje zaključaka na kraju razgovora, pridonijet će značajnom poboljšanju adherencije. S vremenom se znanje i vještina tehnike inhaliranja umanjuje, te je trening potrebno ponavljati najmanje jednom godišnje, a poželjno svaka tri mjeseca, ili na svakoj kontroli bolesnika s astmom ili KOPB-om. Ponavljanje i vježbanje adherencije, kao i tehnike inhalacije, značajno poboljšava obje varijable. Postupak mjerenja adherencije lijekova poboljšava pridržavanje uputama i redovitost uzimanja lijekova. Mjerenje je poželjno provesti u kombinaciji samoprocjene i praćenja utrošenih doza lijeka u ljekarnama.The World Health Organization (WHO) defines adherence as „the extent to which a person’s behavior – taking medication, etc., corresponds to a prescribed regime.” Adherence includes the patient’s consent to agreed health recommendations, which significantly differentiates adherence from compliance. Adherence tests with inhalers in asthma and COPD patients have exhibited upsetting results, where considerably less than half of patients only use the recommended inhaler for basic treatment of asthma or COPD on a regular basis throughout the year. On the other hand, some patients seek relief in short acting beta agonists (SABA) too often, which does not contribute to quality treatment, but instead to poorer control of the disease and increased asthma exacerbations. In addition, asthma patients may fully adhere to preventive treatment when symptoms arise, but become poorly adherent when they are stable and well. It is recommended that a person with asthma or COPD and their physician find the targeted treatment together. A motivational dialogue showing the physician’s positive emotions, empathy, active listening, stimulating questions and clear-cut answers, encouragement and celebration of small successes, as well as recapping conclusions at the end of the conversation, will significantly improve adherence. However, over time, knowledge and skill of the inhalation technique decreases, therefore training should be repeated at least once a year, preferably every three months, or at each medical check-up of asthma or COPD patients. Repeating and practicing adherence and inhalation techniques notably improves both variables. Medication monitoring improves adherence to instructions and regularity of their administration. Monitoring is recommended as a combination of self-assessment and pharmacist assessment by dosage usage
