How to Improve Adherence for Inhalers, Patches, and Injectables

Getting your medication right isn’t just about taking it-it’s about taking it correctly, consistently, and on time. For people using inhalers, patches, or injectables, that’s harder than it sounds. Up to 70% of patients don’t use these devices as prescribed, and the consequences are serious: more hospital visits, worse health, and higher costs. The good news? Simple, proven strategies can make a big difference.

Why Adherence Matters More Than You Think

It’s not just about missing a dose. With inhalers, a wrong technique means the medicine never reaches your lungs. With patches, poor skin contact or early removal cuts effectiveness. With injectables, skipping or mis-timing doses can lead to dangerous spikes or drops in blood levels-especially with insulin or biologics.

According to the CDC, poor medication adherence causes about 125,000 deaths in the U.S. every year. For chronic conditions like asthma, COPD, diabetes, or epilepsy, sticking to your plan isn’t optional-it’s life-saving. And it’s not just about willpower. The barriers are real: confusing instructions, side effects, cost, fear of needles, or just plain forgetfulness.

Fixing Inhaler Use: Technique Is Everything

Most people think they’re using their inhaler right. They’re not. A 2021 study found that fewer than 40% of asthma patients use their inhaler correctly-even after being shown how.

Here’s what actually works:

• Use a spacer. If you’re using a metered-dose inhaler (MDI), a spacer makes a huge difference. It holds the medicine so you can breathe it in slowly, instead of spraying it into your throat. Spacers cost under $20 and work with most inhalers.
• Practice with a trainer. Many pharmacies have free inhaler technique trainers. Ask for one. Practice in front of a mirror. Watch your lips seal around the mouthpiece. Breathe in slowly, hold for 5 seconds, then exhale.
• Try a smart inhaler. Devices like Propeller Health or Adherium attach to your inhaler and track when and how you use it. They sync with your phone and send reminders. In one trial, asthma patients using smart inhalers improved adherence from 55% to 82% in just three months.

But don’t rely on tech alone. One user on Reddit said their smart inhaler app kept crashing. Another said the constant reminders made them anxious. Tech helps-but only if it fits your life.

Making Patches Stick-Literally

Patches are supposed to be easy. Stick it on, forget about it. But skin irritation, sweat, and forgetting to change it ruin the plan.

Here’s how to make patches work better:

• Rotate your spots. Don’t put the patch on the same place every time. Use your upper arm, back, or hip-switch sides weekly. This prevents skin reactions.
• Clean and dry the skin. Wash the area with soap and water, then pat it dry before applying. No lotions, oils, or alcohol wipes-they block absorption.
• Use adhesive aids. If the patch peels off, try medical-grade tape or a transparent film dressing like Tegaderm. They’re available at pharmacies and hold patches in place during showers or workouts.
• Set a calendar alert. Patch changes happen on a schedule-daily, every 3 days, weekly. Set a recurring alarm on your phone labeled “Patch Change: Left Arm.”

For diabetes patients using insulin patches, 73% appreciate the discretion-but 31% say skin irritation makes them skip changes. If you’re having this problem, talk to your doctor. There are different adhesive formulas, and some patches are designed for sensitive skin.

Injectables: Overcoming Fear and Forgetfulness

Injectables-whether insulin, biologics, or hormone therapy-trigger fear, anxiety, and confusion. Many patients delay or skip doses because they’re scared of needles or don’t know how to store them.

Here’s what helps:

• Use smart pens. Novo Nordisk’s connected insulin pens track dose, time, and even injection angle. They send data to an app and remind you if you miss a dose. One study showed a 27% improvement in dose accuracy.
• Keep a log. Write down each injection in a notebook or phone note. Include the time, dose, and how you felt. This helps you spot patterns-like if you always skip your evening dose because you’re tired.
• Store them right. Most injectables need refrigeration. Keep them in a labeled container in the fridge door, so you see them every time you open it. Traveling? Use a cooling wallet (they’re under $30).
• Ask for help. If you’re shaky or have arthritis, ask your pharmacist about auto-injectors. They’re designed for people with limited hand strength.

One user said their smart pen app was too complex for their elderly mom. That’s common. Simplify it: use the pen’s built-in reminder light instead of the app. Or set a voice alarm on a smart speaker: “Alexa, remind me to inject at 8 p.m.”

The 5 Dimensions of Adherence (And How to Fix Each)

Dr. Richard B. Martinello from Yale says adherence isn’t just about remembering. It’s about five things:

1. Affordability - Can you pay for it? If not, ask about patient assistance programs. Many drugmakers offer free or low-cost meds for qualifying incomes.
2. Accessibility - Can you get it? If your pharmacy is far, ask about mail-order delivery or local drop-off points.
3. Acceptability - Do you hate the side effects or the method? Talk to your doctor. Maybe a different formulation exists-like a once-weekly injectable instead of daily pills.
4. Awareness - Do you know how to use it? Get a demo. Watch a video from the manufacturer. Ask your pharmacist to show you again.
5. Activation - Do you feel in control? People who track their own progress-like with a journal or app-are more likely to stick with it.

Fixing just one of these can improve adherence by 20%. Fix two, and you’re looking at 40% gains.

What Actually Works: Evidence-Based Tools

Not all tools are created equal. Here’s what the data says works best:

Pharmacist-led counseling shows the strongest results. A single 20-minute session where the pharmacist asks, “What’s making it hard for you?” can uncover hidden barriers-like fear, cost, or confusion. Follow-ups at 7, 30, and 90 days boost long-term success by 37%.

What Doesn’t Work (And Why)

Some solutions sound great but fall short:

• Just giving a pillbox. It helps with pills, but not inhalers or patches. You can’t put a patch in a pillbox.
• Only relying on tech. Smart devices track use, but not technique. A patient might press the inhaler but not inhale properly. The device says “dose taken”-but the medicine never got to the lungs.
• Blaming the patient. Saying “You just need to be more responsible” ignores real barriers like depression, low health literacy, or financial stress.

Also, don’t ignore the psychological side. Many users say knowing their doctor can see their adherence data motivates them. But 68% worry it could affect insurance. That fear is real-and it’s a barrier too.

Getting Started: Your 3-Step Plan

You don’t need to fix everything at once. Start here:

1. Assess your barrier. Use the Morisky 8-item scale: Answer yes/no to questions like “Do you ever skip doses if you feel worse?” or “Do you forget because you’re traveling?” Count your “yes” answers. 3+ means you need help.
2. Match a tool to your barrier. Forgot doses? Try phone alarms. Hate needles? Ask about auto-injectors. Skin irritation? Try a different patch brand. Cost an issue? Ask about patient assistance programs.
3. Get support. Schedule a 15-minute chat with your pharmacist. Bring your devices. Ask: “Can you watch me use this?” Most will do it for free.

Follow up every 30 days. Did the alarm help? Did the spacer make breathing easier? Adjust as you go.

The Future Is Here-But It’s Not Perfect

By 2027, 75% of inhalers will have built-in tracking. AI will predict when you’re likely to skip a dose and send a nudge before it happens. Patches may soon release medicine only when skin contact is confirmed. Injectables could auto-adjust doses based on your blood sugar.

But tech won’t fix everything. The most effective tools still involve human connection. A nurse calling to check in. A pharmacist remembering your name. A family member reminding you gently.

Adherence isn’t about perfection. It’s about progress. One more dose this week. One fewer missed day. That’s how you take control.