COPD Patients May Reject Medical Advice Due to Treatment Burdens

Patients with chronic obstructive pulmonary disease (COPD) may dismiss medical advice if the benefit of the treatment is insignificant in comparison to the burden of the treatment.

In a recent study, published by Dove Press, researchers attempt to measure the treatment burden for COPD patients through a series of interviews with those affected. Treatment burdens are defined in the study as the additional impact of medical procedures that may negatively affect the functioning and day-to-day life of the patient caused by the treatment, rather than the disease.

The researchers performed in-depth interviews to reveal the influence of treatment burdens in patients' experiences with COPD. Twenty-six patients, all considered to have severe or very severe airflow limitation, participated in a 45-minute interview that explored their prescription treatments, the health behavior changes recommended by their doctors, and their experiences with COPD.

Prior to the interview, the patients participated in a questionnaire to ensure diverse demographics among participants. The demographics considered age, occupation, sex, time since COPD diagnosis, and self-reported medications taken for COPD.

The study discovered common themes among COPD patients, including financial challenges, medications, medical appointment issues, and medical devices and equipment, which the researchers were able to categorize into separate levels—no burden, slight burden, moderate burden, and significant burden.

The researchers found that even the perceived burden of a COPD treatment causes patients to disregard medical advice.

“Generally, the burden associated with smoking cessation outweighed the perceived benefits, and hence participants often disregarded their doctor’s advice and continued smoking until a significant health event occurred,” said the researchers in reference to the difficulties patients have in giving up their smoking habit.

Patients must perceive the benefits of their treatment to be greater than the burdens. As such, the study recommends that doctors set small goals for their patients to achieve and to set out time for the patient to learn and express their treatment preferences. This could change the negative burden perceptions that COPD patients often associate with their treatments that lead to rejecting medical advice.

“Health professionals need to recognize treatment burden as a source of nonadherence, and should tailor treatment discussions to fit patients’ values and capacity to achieve optimal patient outcomes,” the researchers conclude.