Abstract
Factors predicting prescriptions of triple therapy were investigated in a large group of general practitioners in Italy. In the population treated by identified general practitioners, a cohort of newly diagnosed chronic obstructive pulmonary disease patients was extracted from IMS Health Longitudinal Database during the period 2010–2013. From the diagnosis, 1-year follow-up was evaluated. Thirty-two thousand forty-six newly diagnosed chronic obstructive pulmonary disease patients were evaluated (57.7% male, mean age 67 years). During 2 years prior to diagnosis less than 13% of patients were requested with a pulmonology evaluation and less than 5% with a spirometry; 65.1% cases were prescribed with a respiratory drug, which in 9.6% of cases was inhaled corticosteroid/long-acting β2-agonist fixed-dose combination. Two thousand and twenty eight patients (6.3% of the newly diagnosed chronic obstructive pulmonary disease patients) were treated with triple therapy during the first year of follow-up, whose 858 (42.3%) starting immediately, and 762 (37.6%) following an initial treatment with inhaled corticosteroid/long-acting β2-agonist fixed-dose combination. Being older, being requested with pulmonologist evaluation or spirometry, being prescribed with a inhaled corticosteroid/long-acting β2-agonist fixed-dose combination at diagnosis resulted independent predictors of triple therapy use.
Highlights
Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease, characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response to noxious particles or gases in the airways and lungs
In this large general practitioner (GP) setting, following results were found: (1) symptomatic, males, older patients, patients with less comorbidities and patients prescribed with a pulmonology visit or just a spirometry were more likely prescribed with triple therapy; (2) prescription of Inhaled corticosteroids (ICS)/LABA fix dose combination (FDC) at the time of diagnosis and older age seemed to be the strongest predictors for triple therapy use. (3) in the 2 years before the diagnosis few patients were requested
When comparing results about the proportion of patients prescribed with ICS/LABA FDC at the time of the first COPD diagnosis, results from the present study showed a approximate 10% lower proportion than the one found in the above mentioned UK study.[21]
Summary
Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease, characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response to noxious particles or gases in the airways and lungs. Inhaled long-acting bronchodilator therapy consists of long-acting β2 agonists (LABAs), and/or long-acting muscarinic antagonists (LAMAs).[6,7,8,9]
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