How to Take COPD Medications Correctly & Adhere to Your Treatment Plan
If you have COPD, your number one responsibility as a patient is to do what your doctor says and take all your medications as prescribed. This might sound simple on the surface but, in reality, it's much easier said than done.
Like most chronic diseases, COPD is not an easy condition to treat. Many COPD patients have a laundry list of medications and other treatments they have to manage every day.
These medications and treatments are life-saving; they make it easier to breathe and help keep serious COPD symptoms and complications under control. Unfortunately, far too many people with COPD don't take their medications as correctly and consistently as they should.
That's why we've created this guide to show you a variety of practical tips and techniques for managing COPD treatments. We'll show you all the steps you need to take to make sure you use your medications correctly and how to avoid common COPD treatment mistakes.
The more you know about your treatments, the more active role you can take in your health, and the better you will be able to manage your disease. That's why it's important to learn everything you can about your COPD medications and how to use them in the most correct and effective way.
Most People are Bad at Taking Their Medications
How well you take your medications and do the treatments your doctor recommends is a concept known as treatment compliance or medication adherence. Good compliance or adherence means that you follow your doctor's instructions, complete all your treatments, and take all your medications correctly and on time. Poor compliance or adherence simply means that you fail to do at least one of those things consistently.
Unfortunately, a large percentage of people in just about every health and disease category fail to take their medications properly. This is a problem that affects older adults in particular; up to 58% of seniors make mistakes when taking their medication, and more than 25% make a serious mistake.
Studies also show that as many as 63 percent of COPD patients don't take their medications correctly, and that percentage may be even higher if you include improper inhaler use. This high failure rate results in a great deal of unnecessary suffering for those who don't take their medication as prescribed.
In many ways, these statistics are understandable, even as they are still a major cause for concern. COPD treatment regimens can be confusing, time-consuming, and involve many types of medications, which makes them particularly challenging to get right.
COPD Treatment Plans are Complex
COPD is not a static disease; the symptoms get steadily worse over time and they can vary from day to day. What's more, the risk of exacerbation is always around the corner, especially in the later stages of the disease.
Because of this, COPD treatment plans usually change several times over the course of the disease. Many people with COPD also have to follow dynamic treatment plans that involve adjusting their daily treatment according to certain symptom changes.
This type of treatment plan—known as a COPD action plan—helps you keep your symptoms under control when they flare up. However, it also makes treatment more complex and introduces more opportunities to do things wrong.
COPD patients also have a high risk of making mistakes simply because of the sheer number of treatments they have to manage. It's not uncommon for someone with severe COPD to have to take half a dozen medications in addition to supplemental oxygen therapy.
It's Easier to Mess Up Than It Is to Do it Right
When it comes to taking medications, there's a lot that can go wrong. It's easy to make mistakes without realizing it, such as taking the wrong dose or using an empty inhaler.
Every step and instruction for taking your medication is important, and there can be a lot of them to remember. But skipping even one of them can have dangerous consequences that range from worsened symptoms to life-threatening complications.
Unfortunately, people with COPD tend to take medications that are particularly difficult to use, including inhalers, nebulizers, and supplemental oxygen therapy. Doing these treatments correctly can be a difficult skill to master, requiring several steps and precise technique.
Keeping up with these complex treatments is even more challenging for those who are struggling with serious physical or mental symptoms caused by COPD. When you are struggling just to get out of bed, go up the stairs, or remember things, having to adhere to a strict schedule of multiple medications and treatments can be a lot to handle.
What Happens When You Don't Use Medications Correctly: Does it Really Matter?
At this point, you might be wondering if it's really that big of a deal if you don't follow your treatment or medication instructions exactly. The answer is yes, it is a big deal if you don't adhere to your treatment consistently.
You shouldn't mistake the fact that poor treatment compliance is so common for meaning that it's nothing to worry about. It's actually a major issue, which is why COPD doctors and researchers have dedicated so much time and effort to understanding and solving this problem.
However, nobody is perfect, and there's usually no reason to worry if you only make a mistake every once in a while. On the other hand, you should always make it a top priority to take your medications on time and adhere to all the other treatments your doctor prescribes.
If you don't comply with treatment or forget to take your medication too often, it can make it much more difficult to control your symptoms and manage your disease. This leads to worsened breathing problems, exacerbations, and other COPD complications that can hurt your quality of life.
For instance, one study showed that COPD patients who didn't use their inhalers correctly had worse symptoms, including coughing and more severe shortness of breath, than patients who practiced proper inhaler technique.
- Less ability to control COPD symptoms
- Increased shortness of breath
- Increased risk for COPD exacerbations
- Increased risk of death (poor treatment adherence can double or triple your mortality risk)
- More frequent hospitalizations
- Increased health care needs and disease-related costs
- Reduced quality of life
Even things that seem minor, like skipping a step when you use your inhaler, can have a major effect on how well your medication works. You could end up getting too small a dose, too large a dose, or not getting any medication at all.
In some cases, using medications incorrectly can cause dangerous side effects or life-threatening complications. If your supplemental oxygen flow is not set right, for example, it can lead to dangerous breathing problems, including severe hypercapnea (high blood carbon dioxide levels) and death in the most extreme cases.
Are You a Compliant Patient?
When you're taking several medications and have a complex disease, it's normal—and even expected—to make small mistakes here and there. However, those mistakes should be few and far between, and overall you should be following your treatments exactly as prescribed.
Unfortunately, many people don't even realize how poorly they are complying with treatment or how frequently they make mistakes. You might make more mistakes than you realize, which is why it's important to give it some serious consideration.
You can get a better idea of your overall compliance by answering a few yes or no questions about your medication habits. The following questions are part of the Medication Adherence Questionnaire (PDF link), a scale that is used often by doctors and researchers to measure how well a patient is adhering to their medication.
To use this scale, choose either “yes” or “no” as an answer to each question or statement. Choose the answer that is most accurate based on your actions and beliefs during the past week.
Medication Adherence Questions:
- Do you ever forget to take your medication?
- Are you careless at times about taking your medication?
- When you feel better, do you sometimes stop taking your medication?
- Sometimes if you feel worse when you take the medication, do you stop taking it?
If you answered yes to any of these questions, then you probably aren't taking your medication as consistently and correctly as you should. The more questions you respond “yes” to, the poorer your medication adherence is.
You can use these questions to help you identify where things are going wrong, and use that insight to find solutions. You should also tell your doctor if you're having trouble taking your medications as prescribed for any reason; this will not only help your doctor make better decisions about your treatment, but will also give your doctor the opportunity to offer solutions and advice.
Common COPD Medication Mistakes to Avoid
We've talked already about how poor treatment adherence is alarmingly common among people with COPD. However, we haven't talked much about what kinds of mistakes patients are making and what exactly they are failing to do.
Research shows that there are several specific areas of treatment that tend to be the most problematic, including taking medication consistently and using proper inhaler technique. If you or someone you love has COPD, it's important to be aware of these common problems so you can avoid making the same mistakes.
Taking Medications Based on How You Feel
One common, yet dangerous, mistake that patients make is stopping their medication when their COPD symptoms start to get better. Some people think that, because they feel fine, they don't need to continue taking their medication.
However, this is not true; you should always take your medication exactly as your doctor tells you to, regardless of how good or bad your COPD symptoms are. If you notice your symptoms improve, you should take it as a sign that your medication is working, and continue to take it as prescribed.
It's important to trust your doctor's advice and remain diligent about your treatment, even if you sometimes feel like it's not necessary to take your medication. If you have any problems or concerns, bring them up with your doctor instead of trying to take things into your own hands.
You need to take your medications consistently every day in order to keep your symptoms under control. Reducing your dose, stopping your medication, or taking it inconsistently will only make it more difficult to manage your disease.
Not Reading the Instructions
When you pick up your medication from the pharmacy, it usually comes with a packet of papers with detailed information about your medicine. Many people simply ignore this packet or throw it in the trash as soon as they get home.
However, this packet contains all kinds of valuable knowledge meant to help you take your medicine correctly and avoid dangerous mistakes. While it might seem like a lot to go through, you should take the time to read through the whole packet for each medication you take.
If you don't, you could miss vital health warnings or important information about dosages, side-effects, drug interactions, and more. It's also a good idea to keep these information packets in a file at home in case you need to reference them later.
Medical stuff can be tricky, however, and reading about your medication will only help you if you understand what it means. That's what your doctor and pharmacist are there for; they can help you go through the information and explain anything else about the medication that you need to understand.
Not Using Your Inhaler Correctly
Even though inhalers are the main line of treatment for COPD symptoms, the vast majority of people don't actually use them correctly. The numbers are actually quite alarming: up to 90% of COPD patients fail to use proper inhaler technique.
Research also shows that improper inhaler use can significantly affect how well the medication works. It can worsen respiratory symptoms, increase your risk of being hospitalized, and may even double your chances of developing a COPD exacerbation.
Here is a list of some of the most common inhaler mistakes you should avoid (note that some only apply to certain types of inhalers):
- Not using the spacer correctly
- Using an empty inhaler (e.g. not checking the dose counter or making sure there is a spray)
- Not priming the inhaler before use
- Not exhaling before taking a dose
- Not inhaling at the correct time when taking a dose
- Inhaling too quickly
- Not aiming the inhaler correctly (it should spray toward the back of your throat)
- Not holding your breath after taking a dose
- Not using correct head and body posture
- Not rinsing out your mouth after using a steroid inhaler
All of these mistakes can affect your dosage and how well your medication works. That's why it is vital to learn how to use your inhaler correctly and avoid making blunders like these.
Not Using Oxygen As Often As You Should
Poor treatment compliance is a major issue among people with COPD who use supplemental oxygen therapy. This is often due to inconvenience, discomfort, and worries about how it might look in public.
Research shows that a large percentage COPD patients who use long-term supplemental oxygen therapy use oxygen for fewer hours per day than their doctor prescribed. Another 23% of patients refuse to ever use their oxygen outside their homes, in spite of their doctor's instructions to do so.
But even though oxygen therapy can be difficult and uncomfortable, it's very important to use it exactly as you're supposed to. If your doctor prescribes it, then you need it to keep your blood oxygen levels from dropping dangerously low (a condition known as hypoxemia).
Failing to use oxygen correctly will worsen hypoxemia, which can lead to serious health conditions including heart problems, cognitive impairment, respiratory failure, and even death. That's why it's imperative to use your oxygen, and use it correctly, despite how challenging it might be.
It's easy to focus on the negatives, but you should instead try to focus on the fact that oxygen is a life-saving medication that can make your life better rather than worse. It's not always easy to integrate oxygen therapy into your life, but for many people it is a necessary part of treating COPD.
Not Using a COPD Action Plan
Any person who takes medication for COPD should have a proper COPD action plan. This ensures that you always have a clear set of instructions to guide you when taking your daily medications and treatments.
COPD treatment is rarely simple, which is why verbal instructions from your doctor and basic medication schedules aren't enough; you need a clear and thorough written plan. If you don't have a proper COPD action plan to guide you, you will be much more likely to take your medication incorrectly and make other risky mistakes.
Unlike a simple medication schedule, an action plan is dynamic; it tells you how to treat your symptoms based on how severe they are that day. It is essentially a set of several medication schedules with instructions for how and when to use each one.
For example, you would have a plan for typical days, when your symptoms are at baseline, and a different plan for atypical days when you feel worse than you usually do. Each plan tells you which medications—and how much—to take, as well as how you should adjust your activity level and other treatment-related advice.
Once you have an action plan, it's important to make sure you understand it and remember to follow it every day. That means means paying close attention to your symptoms, knowing how to choose the right plan, and knowing what the instructions in each plan mean.
To learn about COPD actions plans and see some examples of what they look like, take a look at our guide on the topic here.
Important Things to Know About Your Medications
In order to take your medications properly, you should have a thorough understanding of each medication and treatment you use. That includes basic things like the correct way to take your medications and how much you're supposed to take, and more detailed information like any interactions they have with other drugs and medications.
Ideally, most of the practical information you need to know about your medication should be included in your COPD action plan. However, your action plan is simply an overview of your treatment, and it won't give you all of the detailed information you need to use your medications responsibly.
The more you learn about your medications, the less likely you are to make errors that could affect your medication or put your health at risk. Here's a quick overview of what you should know and where to get the information you need.
Know the Name and Purpose of Your Medication
First of all, it's important to know the name and the general purpose of each medication you take. In other words, you should be able to answer the following questions: What is your medication called, what do you take it for, and what is it supposed to do?
You need this knowledge to understand your treatment plan and why you need to take your medications. It will also help you better communicate with your doctor and others about your treatment.
Fortunately, this kind of basic information is generally easy to find. You can get it from your doctor, your pharmacist, your prescription info packet, or the information printed on medication bottle or packaging.
However, it's best to get this information first hand from your doctor, who can explain the purpose of your medication in easy-to-understand terms. He can also help you understand how the medication benefits your specific condition, and what kinds of outcomes you can expect.
Know Your Dosage and Frequency
Dosage is everything in medicine; if you get too much or too little of a medication, it can significantly change its effects. That's why, in order to take your medication correctly, you need to know exactly how much medicine you're supposed to take.
This is known as your dosage, and getting it right is vital for ensuring your medication works as it should. Your dose frequency is also important, which simply means you need to know how long you're supposed to wait between each dose.
For example, your medication instructions might say to take a dose every certain number of hours, or give you a maximum number of doses you can take in a 24-hour period. Your doctor might also give you more specific instructions for how often you should take your medication every day.
Know When to Take Your Medications
In many cases, you should take your medication at a specific time every day. For example, your doctor might tell you to use your daily inhaler right after you get up in the morning.
These time-based instructions are important to know and follow, because when you take your medication can affect how well it works. It's also important to keep the dose schedule for each different medication straight; that's where having a detailed medication schedule really comes in handy.
You also need to know when to take medications that are reserved for specific circumstances, such as when your symptoms get worse. You'll likely have a set of medications to take every day (e.g. long-acting bronchodilators), medications you can use as-needed (e.g. a short-acting rescue inhaler), and a set of medications you're only supposed to use when you notice the signs of an oncoming exacerbation (e.g. antibiotics and corticosteroids).
Make sure you know the differences between all these different medications, and know when to use them per your COPD action plan. Pay special attention to as-needed medications like rescue inhalers (and sometimes supplemental oxygen), which can be particularly tricky to use correctly.
Know What to Do if You Miss a Dose
No matter how careful you are, you're bound to accidentally miss a dose sooner or later. Whenever that happens, you'll need to know what to do next.
For example, let's say you just realized that you forgot an inhaler dose that you were supposed to take earlier. Should you go ahead and take the missed dose now, or wait until the next dose you have scheduled?
The answer will likely depend on a variety of things, including the type of medication and how long it's been since the missed dose. If you ask your doctor, he can tell you what to do in a specific case, and how to handle similar situations in the future.
The information that comes with your medication may also give you advice for what to do when you miss a dose. Whatever you do, it's b