Airways disease: just nosing around?

our patients. In a study evaluating metered dose inhaler compliance in COPD, use of an electronic medication monitor with feedback on the accuracy of medication use improved compliance. This type of methodology could be used to improve adherence in COPD outside a clinical trial. Clearly, further research is needed to better understand the factors driving the phenomenon of improved outcomes in adherers. While it is disappointing that neither treatment with active drug nor disease severity had an impact on adherence, study participation was better in the combination treatment arm of the TORCH study which suggests that symptomatic improvement may positively affect the likelihood of compliance of a patient with COPD in the more global sense. This would be good news for our patients as the current analysis also suggests that the association between adherence and mortality risk reduction with combination therapy was even greater when only those in the treatment arm were analysed.