AB034. Comparative effectiveness of prescribing similarversusdissimilar inhalers for COPD therapy
Poster Session

AB034. Comparative effectiveness of prescribing similarversusdissimilar inhalers for COPD therapy

Sinthia Bosnic-Anticevich1, Henry Chrystyn2, Richard Costello3,4, Myrna Dolovich5, Monica Fletcher6, Federico Lavorini7, Roberto Rodríguez-Roisin8, Dermot Ryan9, Simon Wan Yau Ming10, Derek Skinner9, David Price11,12

1School of Medical Sciences, University of Sydney, Australia; 2Research in Real Life, UK; 3RCSI Medicine, Royal College of Surgeons, Ireland; 4RCSI Education & Research Centre, Beaumont Hospital, Beaumont, Dublin 9, Ireland; 5Department of Medicine, Respirology, McMaster University, Canada; 6Education for Health, UK; 7University of Florence, Italy; 8Department of Medicine, University of Barcelona, Barcelona, Spain; 9Optimum Patient Care, UK; 10Research in Real Life, UK; 11Observational and Pragmatic Research Institute, Singapore; 12Academic Primary Care, University of Aberdeen, UK.

Background: Prescription of different inhaler types for patients with chronic obstructive pulmonary disease (COPD) may lead to poorer outcomes through increased demands on patients to master dissimilar inhalation and dose preparation manoeuvres. To describe the demographic, co-morbidity, and clinical characteristics of patients with COPD prescribed ‘dissimilar’versus‘similar’ inhalers.

Methods: The study was a historical cohort observational design assessing a 1-year baseline period for patient characterization and categorisation of inhalers, and an index date to signal the last date of data extraction from the UK Optimum Patient Care Research Database (OPCRD). Patients had 1-year of continuous data between February 2008 and February 2015, a Quality and Outcomes Framework (QOF) coded diagnosis for COPD, were aged 40 and over, and had evidence of two or more inhaled respiratory treatments. Descriptive statistics included demographic, co-morbidity and clinical characteristics of patients, and comparison of patients prescribed similarversusdissimilar inhalers by GOLD group, FEV1, and number of exacerbations. Based on inhalation technique and dose preparation data in the OPCRD, two different categorisations were used to describe prescribed inhaler type: ‘similar inhalers’ included those patients prescribed either aerosols or similar dry-powder inhalers (DPIs), while ‘dissimilar inhalers’ included those prescribed both aerosols and DPIs.

Results: A total of 53,817 patients were selected [mean age of 71 years (SD 10.6); males: 51% in total population]. 13% were non-smokers, 30% current smokers, 52% ex-smokers and 5% with missing smoking status. In the baseline year, 39% received a QOF coded diagnosis for asthma, 36% for diabetes, 26% for ischaemic heart disease, 6% for actively treated rhinitis, and 1.3% for diagnosis for pneumonia. Patients prescribed dissimilar inhalers were of similar age to those prescribed similar inhalers (mean age of 71 in each cohort). The largest contributor for the prescription of dissimilar inhalers was the prescription of short-acting beta-agonists (SABA). Patients in each categorisation were classified according to GOLD group criteria.

Conclusions: The majority of COPD patients were prescribed dissimilar inhalers, with a greater proportion associated with more severe stages of COPD. There is a need for further assessing outcomes for patients with COPD prescribed dissimilar vs. similar inhaler devices.

Keywords: Chronic obstructive pulmonary disease (COPD); inhaler; prescription; effectiveness

doi: 10.21037/jtd.2016.s034

Cite this abstract as: Bosnic-Anticevich S, Chrystyn H, Costello R, Dolovich M, Fletcher M, Lavorini F, Rodríguez-Roisin R, Ryan D, Ming SW, Skinner D, Price D. Comparative effectiveness of prescribing similarversusdissimilar inhalers for COPD therapy. J Thorac Dis 2016;8(Suppl 5):AB034. doi: 10.21037/jtd.2016.s034

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