Changes in COPD inhaler prescriptions in the United Kingdom, 2000 to 2016
| Autor: | Chloe I, Bloom, S L, Elkin, J K, Quint |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors Databases Factual Respiratory System Muscarinic Antagonists International Journal of Chronic Obstructive Pulmonary Disease Drug Prescriptions OBSTRUCTIVE PULMONARY-DISEASE 1102 Cardiovascular Medicine And Haematology Pulmonary Disease Chronic Obstructive Adrenal Cortex Hormones electronic healthcare records BUDESONIDE Administration Inhalation Electronic Health Records Humans COPD inhalers UK Practice Patterns Physicians' Adrenergic beta-2 Receptor Agonists Lung Aged Original Research DYSPNEA SALMETEROL/FLUTICASONE Science & Technology Primary Health Care Nebulizers and Vaporizers DISABILITY Middle Aged PREVENTION United Kingdom Bronchodilator Agents PROPIONATE Drug Combinations EXACERBATIONS Treatment Outcome prescriptions Practice Guidelines as Topic Female Guideline Adherence Life Sciences & Biomedicine TIOTROPIUM |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease |
| Popis: | Chloe I Bloom,1 SL Elkin,2 JK Quint1 1National Heart and Lung Institute, Imperial College London, London SW3 6LR, UK; 2Department of Respiratory Medicine, Imperial College NHS Trust, London, UK Background: Over the past two decades, there have been significant changes in the pharmacological management of COPD, due to an explosion of inhaler trials, and timely updation of national and international guidelines. We sought to describe temporal changes in prescribing practices in the United Kingdom, and some of the factors that may have influenced them.Patients and methods: COPD patients were identified from UK primary care nationally representative electronic healthcare records (Clinical Practice Research Datalink), between 2000 and 2016. Prescription data were described by the three maintenance inhaled medication classes used, inhaled corticosteroids (ICS), long-acting beta agonist (LABA), long-acting muscarinic antagonist (LAMA), and their combinations, dual LABA-ICS, dual LAMA-LABA, or triple therapy LABA-ICS-LAMA. Differing patient characteristics across the six different therapy regimens were measured in 2016.Results: COPD patients were identified: 187,588 prevalent and incident inhaler users and 169,511 incident inhaler users. Since 2002, LAMA showed increasing popularity, while ICS alone exhibited an inverse trend. Triple therapy prescriptions rapidly increased as the first-line therapy until 2014 when LAMA-LABA prescriptions started to increase. By 2014, 41% of all COPD patients were maintained on triple therapy, and 13% were maintained on LAMA only. Characterizing the patients in 2016 revealed that those on triple therapy were more likely to have more severe disease, yet, over a third of patients on triple therapy had only mild disease.Conclusion: UK prescribing practices were not in keeping with national guidelines but did appear to align with evidence from major drug trials and updated international guidelines. There has been a huge upsurge in triple therapy but incident data show this trend is beginning to reverse for initial management. Keywords: COPD, inhalers, UK, prescriptions, electronic healthcare records |
| Databáze: | OpenAIRE |
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