The Global Challenge of Asthma and COPD

Chronic respiratory disease is a worldwide health burden. Globally, it is estimated that 334 million people are currently living with asthma.

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Chronic respiratory disease is a worldwide health burden.1,2

Globally, it is estimated that 334 million people are currently living with asthma.1

According to the WHO, COPD is currently the fourth leading cause of mortality worldwide and is predicted to become the third leading cause by 2030.2

Despite decades of innovation to treat asthma and COPD, a large proportion of patients suffer from inadequate control of their disease, and there is an ongoing underestimation of disease severity.3,4 It is well recognised that treatment adherence and poor inhaler technique can contribute to disease severity and lack of symptom control.5,6,7

Treatment adherence is a growing issue across a multitude of therapy areas, so much so that the WHO has defined it as the ‘new pharmacological problem’.8 In asthma and COPD specifically, mean adherence rates are particularly low, with around half of patients not adhering to treatment.9

This has significant consequences for health, leading to poor health outcomes whilst placing a huge burden on the healthcare resources.10 Adherence is a complex issue, incorporating both intentional and non-intentional factors which are specific to each patient.11

In addition, inhaler technique plays a critical role in the management of chronic respiratory diseases, as issues with inhaler technique demonstrate strong links to inadequate disease control and health outcomes.13

With over a third of patients using their inhaler incorrectly only a month after instruction, training on correct inhaler technique represents a significant unmet need in the treatment of asthma and COPD.14

Multiple factors can influence inhaler technique, such as educational intervention and re-training, yet in some instances, physicians may not know how to use the device correctly themselves.15–20

There is an opportunity for future treatments and technologies to address both inhaler technique and adherence. This, in turn, would have the potential to improve medication delivery, and may lead to better disease control.

At present, individual challenges and unmet needs can be difficult to uncover due to a lack of clear, accurate and reliable data regarding inhaler usage.

With more accurate information, there is potential for more informed conversations between patients and healthcare providers, enhancing the move towards shared decision-making and empowering patients to take a more active role in their treatment.21


  1. Global burden of disease due to asthma. Available at: Accessed: December 2016.
  2. Facts and figures. Available at: Accessed: December 2016.
  3. Jones PW et al. Int J Chron Obstruct Pulmon Dis 2016; 11(Spec Iss).
  4. Sastre J et al. World Allergy Organ J. 2016; 9: 13.
  5. Rifaat N et al. Egyptian Society of Chest Diseases and Tuberculosis 2013; 62: 371–376.
  6. Price DB. et al J Allergy Clin Immunol Pract 2017; 5(4): 1071–1081.e9.
  7. Vestbo J et al. Thorax 2009; 64: 939–943.
  8. Sanduzzi A et al. Multidiscip Respir Med. 2014; 9(1): 60.
  9. Hansen R et al. Transplant Proc. 2007; 39(5): 1287–1300.
  10. Most Recent Asthma Data. Available at: Accessed: December 2016.
  11. Sulaiman I et al. Am J Respir Crit Care Med 2017; 15: 195(10): 1333–1343.
  12. Heaney LG and McGarvey LPA Respiration. 2017; 93: 153–161.
  13. Melani AS et al. Respir Med. 2011; 105(6): 930–938.
  14. Ovchinikova L et al. J Asthma. 2011; 48(6): 616–624.
  15. Giraud V et al. Respir Med 2011; 105: 1815–1822.
  16. Braido F et al. J Allergy Clin Immunol Pract 2016; 4(5): 823–832.
  17. Chopra N. Ann Allergy Asthma Immunol. 2002; 88(4): 395–400.
  18. Plaza V et al. Respiration. 1998; 65(3): 195–198.
  19. Jones JS et al. Ann Emerg Med. 1995; 26(3): 308–311.
  20. Interiano B et al. Arch Intern Med. 1993; 153(1): 81–85.
  21. Sapir T et al. Ann Am Thorac Soc 2017; 14(5): 659-666.
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