The impact of medication adherence on lung health outcomes in cystic fibrosis.
OBJECTIVE
As new medications continue to come to market to improve health in individuals with cystic fibrosis (CF), patient adherence is increasingly more important to address. Currently, adherence for pulmonary medications is approximately 50% for people with CF. There has been recent research that has demonstrated that poor adherence is linked to worse health outcomes. This review summarizes recent research on the impact of adherence on lung health and highlights future areas of research and clinical practice to address this growing need.


RESULTS
Recent research has indicated that nonadherence is associated with increased hospitalizations and pulmonary exacerbations, lower baseline lung function, and longer length of stays. However, most of the research has been done using pharmacy refill records as an objective measure of adherence. Electronic monitoring of medications provides more detailed information about patterns of use, which can directly inform clinical care. Furthermore, there have been few published clinical trials evaluating behavioral interventions to promote adherence.


CONCLUSIONS
Given the recent research linking adherence to lung health outcomes, there is a growing need to measure and evaluate adherence in clinical care. As new medications are approved for CF, methods to monitor adherence also need to be developed and approved. Clinicians need to continue to assess barriers to adherence to be able to individually tailor interventions to a patient's needs.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Michelle N
MN
Eakin
Kristin A
KA
Riekert
D001294:Attitude to Health; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D018450:Disease Progression; D005260:Female; D017408:Guidelines as Topic; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D018670:Monitoring, Ambulatory; D010353:Patient Education as Topic; D013315:Stress, Psychological; D016903:Drug Monitoring