Obstructive lung diseases at an outpatient clinic Phenotypes and non-pharmacological treatment outcomes

Both asthma and COPD are chronic obstructive pulmonary diseases that have been known since long time. Significant efforts have been made to clearly define these two diseases and to create treatment guidelines with diagnostic criteria for each. However, diagnosing these diseases appears to be more complex than originally thought: asthma and COPD are heterogeneous illnesses and, as such, they exhibit multiple (overlapping) phenotypes.
Both (inhalation) medication and non-pharmacological therapies are important in the treatment of patients with chronic obstructive lung diseases. Inhaled drug therapy is the cornerstone of the pharmacological treatment option; the choice of medication(s) depends on the diagnosis and disease characteristics. Education, reconditioning, self-management and coaching by healthcare professionals are all major components of the non-pharmacological treatment option for patients with a chronic disease. The aim of non-pharmacological treatment is to motivate, engage and coach patients to adapt their health behaviour(s) and to develop the necessary skills to better manage their disease.
In this thesis, we investigated the different phenotypes of patients with obstructive lung disease (diagnosed as asthma and COPD) in a regular pulmonary outpatient clinic. As a reliable assessment of the care outcomes is important, we developed and clinimetrically evaluated two instruments before employing them in this thesis. An educational intervention was evaluated and the determinants of an incorrect inhalation technique were investigated.