CROSS-SECTIONAL SURVEY TO ASSESS COPD MEDICATION USE BY UNITED STATES PHYSICIANS

Abstract

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Little information is available on the reasoning behind prescribing behaviors for specific COPD medications and classes by US primary care physicians (PCPs) and pulmonologists (Pulms). There is also a lack of information on how well these prescribers align with COPD treatment strategies, including those from the Global Initiative for Obstructive Lung Disease (GOLD) and the COPD Foundation. This study aimed to better understand COPD maintenance medication use by US physicians. METHODS: This was a retrospective analysis of Adelphi Respiratory Disease Specific Programme™ data, which surveyed physicians from July-December 2019. Physicians were presented with four COPD patient types and asked which treatment class they would use for each: 1) Maintenance-naïve, symptomatic COPD, significant exacerbation risk; 2) Maintenance-naïve, symptomatic COPD, recent exacerbation history; 3) Symptomatic COPD, no exacerbations in the past year, moderate dyspnea; 4) Symptomatic COPD, no exacerbations in the past year, severe dyspnea. The information was collected via completed questionnaires on disease management and case reports. All results were reported descriptively and no statistical testing was performed. RESULTS: There were 43 PCPs and 32 Pulms surveyed, covering a total of 800 COPD patients (408 PCP and 392 Pulms). Overall, PCPs used ICS/LABA at a higher rate than Pulms (50.4% vs 39.6%), as well as LAMA (33.2% vs 31.5%). LAMA/LABA (18.4% vs 13.5%) and ICS/LABA/LAMA (14.8% vs 7.9%) were used more by Pulms than PCPs. Patient 1, PCPs chose ICS/LABA (53.5%), LAMA (32.6%), and LAMA/LABA (18.6%); Pulms reported ICS/LABA/LAMA (37.5%), ICS/LABA (28.1%), and LAMA (15.6%) or LAMA/LABA (15.6%). Patient 2, PCPs chose ICS/LABA (55.8%), LABA/LAMA (44.2%), and LAMA (37.2%); Pulms reported LABA/LAMA (40.6%), ICS/LABA/LAMA (28.1%), and ICS/LABA (28.1%). Patient 3, PCPs chose ICS/LABA (39.5%), LAMA (30.2%), and LABA/LAMA (23.3%); Pulms chose ICS/LABA (37.5%), LABA/LAMA (34.4%), and LAMA (31.3%). Patient 4, PCPs chose ICS/LABA (55.8%), LAMA (30.2%), and ICS/LABA/LAMA (23.3%); Pulms chose LABA/LAMA (43.8%), ICS/LABA (28.1%), and LAMA (18.8%). Overall, 79.1% of PCPs and 71.9% of Pulms reported that they refer to clinical strategies when making treatment decisions. The majority reported adhering to GOLD strategies (PCPs 79.4%, Pulms 91.3%). CONCLUSIONS: This real-world data indicates that PCPs and Pulms utilize treatments for COPD at very different rates. Pulms were more likely to utilize dual bronchodilation than PCPs. PCPs were more likely to suggest ICS/LABA than Pulms. When presented with patient profiles, choices differed markedly between provider type. Most of the providers reported referring to clinical strategies. CLINICAL IMPLICATIONS: A better understanding of patient types that benefit from each treatment option could help to optimize patient care in COPD. DISCLOSURES: Employee relationship with GlaxoSmithKline Please note: >$100000 Added 03/03/2020 by Michael Bogart, source=Web Response, value=Salary No relevant relationships by Adam Haq, source=Web Response Employee relationship with GlaxoSmithKline Please note: >$100000 Added 04/30/2020 by David Mannino, source=Web Response, value=Salary No relevant relationships by James Siddall, source=Web Response No relevant relationships by Mark Small, source=Web Response