Abstract
BackgroundThe extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010.MethodsWe performed a trend analysis using data from up to 1426 participants aged ≥20 years with self-reported COPD from six national surveys (National Health and Nutrition Examination Survey 1999–2010).ResultsDuring 2009–2010, the age-adjusted percentage of participants who used any kind of medication was 44.2%. Also during 2009–2010, the most commonly used medications were short-acting agents (36.0%), inhaled corticosteroids (ICS) (18.3%), and LABAs (16.7%). The use of long-acting beta-2 agonists (LABAs) (p for trend <0.001), ICS (p for trend = 0.013) increased significantly over the 12-year period. Furthermore, the use of tiotropium increased rapidly during this period (p for trend <0.001). For the years 2005–2010, the use of LABAs, ICS and tiotropium increased with age. Compared with whites, Mexican Americans were less likely to use short-acting agents, LABAs, ICS, tiotropium, and any kind of COPD medication. Among participants aged 20–79 years with spirometry measurements during 2007–2010, the use of any medication was reported by 19.0% of those with a moderate/severe obstructive impairment and by 72.6% of those with self-reported COPD and any obstructive impairment.ConclusionThe percentages of adults with COPD who reported having various classes of prescription medications that improve airflow limitations changed markedly from 1999–2000 to 2009–2010. However, many adults with COPD did not report having recommended prescription medications.
Highlights
Because of the chronic and often progressive nature of COPD, treatment is paramount in reducing symptoms, improving quality of life and health status, enhancing exercise capacity, slowing deterioration of lung function, limiting exacerbations, and prolonging the life of patients with COPD [1,2]
Treatment options for prescription medications directed at the underlying airflow limitation have evolved over time; whereas the mainstay of treatment several decades ago included primarily methylxanthines and short-acting beta-2 agonists, treatment has gradually shifted to emphasize increasingly the use of long-acting beta-2 agonists and inhaled corticosteroids (ICS)
The numbers of participants aged $20 years who were interviewed for the six consecutive cycles were 4880, 5411, 5041, 4979, 5935, and 6218, and the numbers of participants who reported having been told that they had COPD were 213, 208 (3.5%), 234 (4.3%), 212 (4.4%), 314 (4.3%), and 245 (3.3%)
Summary
Because of the chronic and often progressive nature of COPD, treatment is paramount in reducing symptoms, improving quality of life and health status, enhancing exercise capacity, slowing deterioration of lung function, limiting exacerbations, and prolonging the life of patients with COPD [1,2]. Management of these patients encompasses several critical elements which include 1) reducing or preferably eliminating exposure to the offending agent that caused COPD; 2) prescribing medications as indicated; 3) use of oxygen when indicated; 4) pulmonary rehabilitation; and 5) reducing exacerbations. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010
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