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Patient needs and medication styles in COPD

L. M. Osman^* and M. E. Hyland

^* Chest Clinic, Aberdeen Royal Infirmary, Aberdeen, and University of Plymouth, Plymouth, UK.

CORRESPONDENCE: L. M. Osman, Senior Research Fellow, Chest Clinic, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK. Fax: 44 1224551210. E-mail: med078{at}abdn.ac.uk

Patient self-care in illnesses such as chronic obstructive pulmonary disease (COPD) is influenced by "trade-offs" that patients make between their social and psychological needs, and the "best practice" clinical management of their illness. Patients weigh the benefits of taking medication against the costs, such as symptoms.

Personal styles of medication use and decision-making also affect how well COPD patients respond to treatment plans and their acceptance of particular treatments, including inhalers. The large amount of information now available may have made patients more autonomous than before, but the actual locus of control varies widely between patients. Patients seem to take a pragmatic approach when assessing inhaler devices, basing preference on how effective they perceive the device to be. Patients with COPD show loyalty to devices and, in the main, try to comply with instructions given by the healthcare provider.

The health path for chronic obstructive pulmonary disease, which describes the course the disease typically takes, is a progressive deterioration. Patients therefore adopt a conservative attitude to their health goals and what they expect to gain from treatment and management plans. An understanding of these influences will help healthcare providers support the patient better and give the appropriate advice at each phase of a patient's health path.

KEYWORDS: Attitudes, chronic obstructive pulmonary disease, inhaler, medication, patient