A qualitative study of compliance with medication and lifestyle modification in Chronic Obstructive Pulmonary Disease (COPD).

AIM: The aim of this study is to examine patients' perceptions of factors that influence their compliance with inhaled therapy for COPD, and their compliance with health related behaviours related to smoking cessation, exercise and diet.
METHODS: Five focus groups of 29 diagnosed COPD patients who had not attended pulmonary rehabilitation were recruited from secondary and primary care. The severity of their illness ranged from mild to severe. For each group, the moderator asked patients what they had been told and what they actually did with regard to medication, smoking, exercise and diet.
RESULTS: All patients except one reported good compliance with medication but some patients expressed concerns about technique. All patients reported being told to stop smoking, but patients varied as to whether they believed that smoking was harmful or not. Some had stopped smoking, some had tried to cut down, and others continued as normal. Patients had not been offered constructive help to quit smoking. Patients had been told to exercise but were given inadequate information as to why this was helpful. Patients were unsure how much they should exercise, and were unsure whether breathlessness during exercise was harmful. Patients had been given minimal advice about diet.
CONCLUSIONS: Patients with COPD have low levels of intentional non-compliance with medication in COPD, probably because, unlike asthmatics, these patients are chronically symptomatic. Fear of dyspnoea and feelings of vulnerability also appear to contribute to good compliance. Information given by health professionals about lifestyle modification was poor. COPD patients require better education to manage their disease effectively.