IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) E-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 7, Issue 6 (Mar.- Apr. 2013), PP 34-38 www.iosrjournals.org www.iosrjournals.org 34 | Page ‘Compliance in Chronic Obstructive Pulmonary Disease Patients Attending Pulmonary Medicine OPD in a Tertiary Care Hospital: Prospective study’ Dr. Anshu Gupta 1, Dr. Dinesh Mehta 2, Dr. Sulbha Singla 3, Dr. Kusum Singla 4 1. Assistant professor. Dept. of Pharmacology, MMIMSR, Mullana, Ambala, Haryana, India. 2. Assistant Professor Dept. of Pulmonary medicine, MMIMSR, Mullana, Ambala, Haryana, India. 3. Post Graduate Student, Dept. of Pulmonary medicine, MMIMSR, Mullana, Ambala, Haryana, India. 4. Post Graduate Student, Dept. of Biochemistry, MMIMSR, Mullana, Ambala, Haryana, India Abstract: Non Compliance in patients with Chronic Obstructive Pulmonary Disease (COPD) to the medication can result in worsening of the disease and increases the hospital admissions. This study aimed at examining the dimensions of compliance to the medication, life style modification and smoking cessation in 60 COPD patients. A pre validated questionnaire was administered at 0 week, 2 weeks and at 6 weeks. Ninety percent of the patients took the prescribed oral drugs in correct dose, correct timings and 77% complied to hospital visits. In contrast to oral drugs only 36% of the patients were compliant to the use of inhaler at the first visit which improved to 59%. Life style changes related to diet and exercise were followed by 32% patients. Only 19% of patients quit smoking. In order to improve compliance levels repeated counseling or stressing the importance of use of inhalers and quitting smoking was found an effective method. Key Words: Chronic Obstructive Pulmonary Disease (COPD), Compliance, Smoking cessation, Inhalers. I. Introduction Chronic Obstructive Pulmonary Disease (COPD) is characterized by an irreversible decline in lung function, exercise capacity and health status. 1 COPD is a chronic illness and poor adherence of patients to the disease management may result in increased rate of morbidity, health care expenditures, hospitalizations and reduced Quality of Life (QoL). There can be increase in the dose of therapy. It can be affected by the various perceptions of the patient about the disease, social beliefs, type of treatment and medication, quality of service provider and social environment. 2 Many of times there is acute clinical worsening of disease and it may necessitate a change in regular therapy. Majority of exacerbations are not reported and most likely not treated. These events have clinically relevant impact on Health Related Quality of Life (HRQoL). 1 International guidelines for the treatment of COPD recommend therapy with one or more bronchodilators in patients with moderate disease, and addition of an inhaled corticosteroid in patients with severe or very severe COPD. Bronchodilators which are long acting are preferred over the short acting agents. 3 According to Jing Jin et al. compliance is the extent to which the behavior of the patient corresponds in terms of taking medication, following diet instructions or executing life style changes with agreed recommendations of from a health care provider. 4 It is often defined as the extent to which a person behavior coincides with the clinical prescription. There are various compliance factors i.e. Patient related factors, regimen related factors and health care provider related factors. 2,4 In this study the patients were prescribed bronchodilators, anticholinergics, and inhaled corticosteroids. Drugs were prescribed according to the severity of disease. Several studies have shown that combination of long acting B-agonist with an inhaled corticosteroid offered additional bronchodilator efficacy over a bronchodilator alone. 5 In this study we are taking into consideration the patient related factors including the demographic factors such as age, sex, marital status, ethnicity, severity of the disease. Compliance factors: knowledge about the disease, regimen and benefits and beliefs about the disease. Assessment of the disease was done by the physical examination, chest X-ray, blood biochemistry and spirometry. FEV1 and FEV1/ FVC ratio was done on each patient on the first visit.