TOWARD - giving choice may give value in COPD management

Coproduction and working together is an important principle of Prudent Healthcare. We know that taking treatment regularly improves clinical outcomes as well as quality of life. Concordance with inhaler use is often poor in COPD and being satisfied with your inhaler improves this. Giving choice may improve satisfaction. Part of the TOWARD (sTep dOWn inhalers in the reAl world) COPD research study allowed the patient to choose their inhaler device from four alternatives and this was prescribed if they were able to demonstrate effective use.

In this small study, there was a significant increase in concordance (p=<0.001) over 12 months compared to the participants preceding year. Taking an 80% concordance rate as a minimum acceptable threshold, 95% of participants met this compared to only 73% prior to entry onto the study.

There may be many explanations for this important increase but we believe coproduction, choice and satisfaction play an important part. This requires further research as it could influence our practice and achieve important clinical improvements, proving value for both patients and organisations.

Association of Respiratory Nurse Annual Conference 2019: Poster Presentation 1st Prize Award

J Annandale, Prof K E Lewis

Hywel Dda University Health Board, Respiratory Innovation Wales, Swansea University