Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice
Autor: | Martina Teichert, Tjard Schermer, Michel Wensing, Anne Rutjes, Victor van der Meer, Gerben Stege, Lisette van den Bemt, Lotte van den Nieuwenhof |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Exacerbation medicine.drug_class Health Status Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Therapeutics Article Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Pulmonary Disease Chronic Obstructive All institutes and research themes of the Radboud University Medical Center Adrenal Cortex Hormones Internal medicine Bronchodilator Administration Inhalation medicine Humans In patient Aged lcsh:RC705-779 COPD business.industry Chronic obstructive pulmonary disease Public Health Environmental and Occupational Health Severe exacerbation lcsh:Diseases of the respiratory system medicine.disease Pragmatic trial Clinical trial design Bronchodilator Agents Dyspnea Withholding Treatment General practice Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] Quality of Life Corticosteroid Female business |
Zdroj: | npj Primary Care Respiratory Medicine, 30(1). NATURE RESEARCH npj Primary Care Respiratory Medicine, Vol 30, Iss 1, Pp 1-8 (2020) NPJ Primary Care Respiratory Medicine Npj Primary Care Respiratory Medicine, 30, 1 Npj Primary Care Respiratory Medicine, 30 |
ISSN: | 2055-1010 |
Popis: | The therapeutic value of inhaled corticosteroids (ICSs) for COPD is limited. In published RCTs, ICS could be withdrawn in COPD patients without increasing exacerbation risk when bronchodilator treatment is optimized. Here we report on the feasibility and risks of ICS withdrawal in Dutch general practice for COPD patients without an indication for ICSs. In our pragmatic trial, general practitioners decided autonomously which of their COPD patients on ICS treatment could stop this, how this was done, and whether additional bronchodilator therapy was needed. We recruited 62 COPD patients (58 analysed) who were eligible for ICS withdrawal in 79 practices. In 32 patients (55.2%, 95% CI: 42.5–67.3%) ICS was withdrawn successfully, 19 (32.8%, 95% CI: 22.1–45.6%) restarted ICS treatment within six months, 12 patients (20.7%, 95% CI: 12.3–32.8%) had a moderate exacerbation, and one patient had a severe exacerbation. ICS withdrawal was successful in just over half of the patients with COPD without an indication for ICS. |
Databáze: | OpenAIRE |
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