Contemporary Challenges in the Management of Asthma and Chronic Obstructive Pulmonary Disease: Expert Perspectives on Optimising Outcomes Through Guidelines Implementation, Inhaler Selection, and Patient Engagement

Abstract

Asthma and chronic obstructive pulmonary disease (COPD) affect millions of people throughout Europe, being one of the leading causes of death in the continent. Both conditions also impose considerable morbidity on patients, adversely affecting individuals’ physical and psychological wellbeing, and their capacity to live and work normally. Asthma and COPD also impose a substantial economic burden on healthcare providers and wider society through both direct and indirect costs of care. Inhaler-delivered therapy has been central to the successful management of both conditions for several decades. Advances in device technology and understanding of the pathophysiology of both conditions (while theoretically introducing greater flexibility and responsiveness into the repertoire of inhalation therapies) have also added complexity and sometimes confusion into the task of identifying the precise combination of medication and delivery device best suited to the needs of individual patients. Recently published multinational consensus reports have set out best-practice frameworks for the management of both asthma and COPD. Presentations at the two symposia summarised in this report examined the implications of these guidelines for the treatment of both conditions. Special focus was on dry power inhalers (DPI) as a means of delivering effective treatment that combines ease of use and widespread acceptance among patients, with the potential to reduce medically-related emissions of greenhouses gases compared with pressurised metered-dose inhalers (pMDI). The authors emphasised the importance of patient partnership in determining the care plan, including the choice of both inhaler device and treatment; the benefits of regular monitoring of adherence to the treatment for both patients with asthma and COPD; and the benefits of simplicity, using one type of inhaler where possible to minimise critical errors in inhalation technique.