Bronchodilators use in patients with COPD
Journal
International Journal of COPD
Journal Volume
10
Journal Issue
1
Pages
1769-1779
Date Issued
2015
Author(s)
Abstract
Background: Bronchodilators are commonly used as maintenance and rescue therapy in patients with COPD. We aimed to examine the prescribing patterns of bronchodilators in clinical practice. Methods: We identified patients with COPD who initiated oral or inhaled bronchodilators between 2001 and 2010 from the Taiwan National Health Insurance Research Database. We followed the patients for 1 year. For bronchodilator prescriptions, we classified the treatments based on medication classes and regimens (oral bronchodilators alone, oral and inhaled bronchodilators in combination, or inhaled bronchodilators alone). For inhaled bronchodilator prescriptions, we further classified the treatments as short-acting bronchodilators alone, short-acting and long-acting bronchodilators in combination, and long-acting bronchodilators alone. We evaluated the prescribing patterns and the change with time, in different physician specialists, and in different hospital accreditation levels. Results: Among a cohort of 4,387 study-eligible patients, we identified 21,235 bronchodilator prescriptions for the analysis. The majority of prescriptions were oral xanthines or beta-2 agonists (62.63% and 47.54%, respectively) rather than prescriptions for inhaled bronchodilators (less than 10%). Nearly 80% of prescriptions were oral bronchodilator alone regimens. Use of oral bronchodilators declined with time and varied with health care providers, which were most commonly prescribed by non-chest specialists and in primary care clinics. Despite limited use of inhaled bronchodilators, it was noted that short-acting bronchodilators alone regimens accounted for 60% of the inhaled bronchodilator prescriptions. Conclusion: Excessive use of oral and short-acting bronchodilators is noted in general practice. Further research and education programs are warranted to decrease inadequate oral bronchodilators and optimize inhaled treatments in the management of patients with COPD. ? 2015 Dong et al.
SDGs
Other Subjects
beta 2 adrenergic receptor stimulating agent; bronchodilating agent; corticosteroid; long acting drug; muscarinic receptor blocking agent; short acting drug; xanthine derivative; bronchodilating agent; adult; Article; chronic obstructive lung disease; female; general practice; human; major clinical study; male; medical specialist; monotherapy; prescription; Taiwan; accreditation; aged; clinical practice; combination drug therapy; comparative study; drug utilization review; factual database; inhalational drug administration; middle aged; oral drug administration; pathophysiology; practice guideline; protocol compliance; Pulmonary Disease, Chronic Obstructive; specialization; time factor; trends; Accreditation; Administration, Inhalation; Administration, Oral; Aged; Bronchodilator Agents; Databases, Factual; Drug Prescriptions; Drug Therapy, Combination; Drug Utilization Review; Female; Guideline Adherence; Humans; Male; Middle Aged; Practice Guidelines as Topic; Practice Patterns, Physicians'; Pulmonary Disease, Chronic Obstructive; Specialization; Taiwan; Time Factors
Publisher
Dove Medical Press Ltd.
Type
journal article