Once the de-escalation began after the confinement that began on March 13, the difficult thing really comes for the experts and the citizens. Preventing new infections of SARS-CoV-2 is the priority, and even more so, in the so-called risk patients. It is true that they are not more likely to contract the infection, but if they do, its consequences can be much worse. Among these people are those affected by COPD, a disease that causes 29,000 deaths a year in Spain.
In addition to adopting extreme distance and hygiene measures, another aspect to take into account is the control of patients, that is, that they keep the symptoms derived from their condition at bay. However, half of COPD patients do not comply with the treatment that their doctor has prescribed. This is stated by Pilar de Lucas, member of the Scientific Committee of the OAT Group (Observatory of Adherence to Treatment). De Lucas points out that this lack of observance translates into less control of the disease and, therefore, more symptoms and relapses for which patients end up going to hospitals.
For patients affected by exacerbations or acute episodes of symptoms, those who suffer from a combined syndrome of COPD and asthma, or with features typical of chronic bronchitis or emphysema, it is essential to combine different drugs.
The importance of taking prescribed medication
And one of the problems generated by the fact that a patient has to resort to several treatments is the so-called lack of adherence: speaking clearly, that he does not take all the doses that are prescribed.
Precisely, one of the great advances in COPD in recent years is the development of triple fixed therapy, which combines three active principles based on a sum of corticosteroids and bronchodilators in a single inhaler. They have been shown to dramatically improve efficacy over previously available treatments. Thus, today there are two triple fixed combinations with the three drugs in the same device, which must be used once or twice a day. “Inhaled medication is key. We need to have devices that help the patient to be constant by simplifying their administration ”, emphasizes Julio Ancochea, head of the Pneumology Service at Hospital La Princesa in Madrid. And, as Dr. Ancochea points out, the benefits provided by this treatment are more than scientifically proven.
However, accessing triple therapy is not easy. The Ministry of Health has imposed a visa that makes its prescription and dispensing difficult, through which doctors must justify that a series of established guidelines are met so that the patient can obtain the medication. According to José Luis López Campos, pulmonologist and coordinator of the COPD area of the Spanish Society of Pulmonology and Thoracic Surgery (Separ), this procedure hinders the prescription of drugs as indicated in their technical data sheet.
At the outbreak of the COVID-19 pandemic, only the Community of Madrid decided to automatically renew all prescriptions for patients with chronic disease, as well as to eliminate visas. This decision sought to prevent patients from going to health centers, in order to minimize the risk of transmission of SARS-CoV-2. Now, those affected ask that the measure be maintained in the long term and demand that it be extended to the rest of the communities. “Adherence to treatment has always been important, but now it is more so”, emphasizes Dr. De Lucas.
By Monica Gail
