Drug Prescription for Chronic Obstructive Pulmonary Disease and Asthma by Primary Care Physicians in the Spanish Autonomous Community of Madrid, 1996-2002

Abstract

To identify trends in the drug prescription used to treat chronic obstructive pulmonary disease (COPD) and asthma at the primary care level in Madrid between 1996 and 2002, and to assess the repercussion of new treatments. We analyzed information on primary care general practitioners' and pediatricians drug prescription from the R03 group (drugs for obstructive airway diseases) of the Anatomical Therapeutic Chemical Classification System. Drug consumption was measured by recording the number of packages charged to the Spanish National Health Service and dispensed in pharmacies in the Spanish autonomous community of Madrid between 1999 and 2002. Consumption was expressed as defined daily dose per 1000 inhabitants per day. Drug use expressed as defined daily dose per 1000 inhabitants per day for COPD and asthma in Madrid increased by 18.48% between 1996 and 2002. The use of inhalants increased by 33.5% over the same period. The most marked differences were the increase in the number of patients treated with selective beta2 adrenergic agonists, anticholinergics, and combinations of fixed doses of long acting beta2 agonists with corticosteroids. The most-used drugs in 2002 were selective beta2 adrenergic agonist inhalants (37.7%), anticholinergics (22.5%), corticosteroids (19.5%), combinations of fixed doses of long acting beta2 adrenergic agonists with corticosteroids (10.5%) band xanthines (5.03%). In 2002, the prescription of 5 new treatments amounted to 15.76% of total use of COPD and asthma drugs (R03 group). Drug use for obstructive diseases of the airways showed a sharp increase between 1996 and 2002. Changes in patterns of use were observed, new treatments being quickly adopted, modifying the profile of drug prescription for the management of COPD and asthma.