ArticleBMC family practice2014
Predictors of ICS/LABA prescribing in COPD patients: a study from general practice.
Article in BMC family practice, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA) versus LABA plus inhaled corticosteroid (ICS) for stable chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2023Pooled it
- Long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA) versus LABA plus inhaled corticosteroid (ICS) for stable chronic obstructive pulmonary disease (COPD).The Cochrane database of systematic reviews · 2017Pooled it
- Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.PloS one · 2015Pooled it
- Use of concomitant inhaled corticosteroids: pooled data from two phase III studies of aclidinium plus formoterol in COPD.NPJ primary care respiratory medicine · 2017Trial
- The lung function profile of once-daily tiotropium and olodaterol via Respimat(®) is superior to that of twice-daily salmeterol and fluticasone propionate via Accuhaler(®) (ENERGITO(®) study).International journal of chronic obstructive pulmonary disease · 2016Trial
- Clinical Management of COPD in the Real World: Can Studies Reveal Errors in Management and Pathways to Improve Patient Care?Pragmatic and observational research · 2023Review
- Deciphering patterns of respiratory medication use in Ireland to target interventions appropriately: a focus on COPD.Irish journal of medical science · 2021Article
- Effectiveness and Safety of COPD Maintenance Therapy with Tiotropium/Olodaterol versus LABA/ICS in a US Claims Database.Advances in therapy · 2021Observational
- Inhaled Corticosteroid Treatment Regimens and Health Outcomes in a UK COPD Population Study.International journal of chronic obstructive pulmonary disease · 2020Article
- Distribution, Temporal Stability and Appropriateness of Therapy of Patients With COPD in the UK in Relation to GOLD 2019.EClinicalMedicine · 2019Article
- Health Care Resource Utilization and Exacerbation Rates in Patients with COPD Stratified by Disease Severity in a Commercially Insured Population.Journal of managed care & specialty pharmacy · 2019Article
- Real-world effectiveness of umeclidinium/vilanterol versus fluticasone propionate/salmeterol as initial maintenance therapy for chronic obstructive pulmonary disease (COPD): a retrospective cohort study.International journal of chronic obstructive pulmonary disease · 2019Observational
- Guideline adherence in hospital recruited and population based COPD patients.BMC pulmonary medicine · 2018Observational
- A cross-sectional survey of current treatment and symptom burden of patients with COPD consulting for routine care according to GOLD 2014 classifications.International journal of chronic obstructive pulmonary disease · 2017Article
- First maintenance therapy for COPD in the UK between 2009 and 2012: a retrospective database analysis.NPJ primary care respiratory medicine · 2016Article
- Changes in initial COPD treatment choice over time and factors influencing prescribing decisions in UK primary care: in UK primary care: a real-world, retrospective, observational.NPJ primary care respiratory medicine · 2016Observational
- Impact of lung function on exacerbations, health care utilization, and costs among patients with COPD.International journal of chronic obstructive pulmonary disease · 2016Observational
- Using Big Data to Assess Prescribing Patterns in Greece: The Case of Chronic Obstructive Pulmonary Disease.PloS one · 2016Observational
- COPD patients' characteristics, usual care, and adherence to guidelines: the Greek UNLOCK study.International journal of chronic obstructive pulmonary diseaseArticle
- Towards Rational Prescription of Common Inhaler Medication in the Multimorbid COPD Patient.International journal of chronic obstructive pulmonary diseaseArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA combination of inhaled corticosteroid and long-acting beta2 agonist (ICS/LABA) is used frequently to treat chronic obstructive pulmonary disease (COPD) patients. The aim of the study was to determine whether prescribing ICS/LABA to COPD patients in primary care in 2009/10 was within the GOLD guidelines and whether and to what degree patient characteristics were associated with prescription of these drugs by GPs.
methodsThis was a cross-sectional study in seven Norwegian GP practices. Patients registered with a diagnosis of asthma or COPD in the previous five years were included.
resultsAmong the 376 patients included in the analysis, 149 patients had COPD, defined as a post-bronchodilator FEV1/FVC <0.7 and 55.6% of these patients were treated with ICS/LABA. The rate of prescribing was significantly higher in the COPD patients also diagnosed with asthma than in those with COPD as the only diagnosis, 66.7%, and 39.0%, respectively (P = 0.001). The prescribing rate in the latter subgroup would have been 18.6% if the 2007 GOLD guidelines had been followed. One or more exacerbations in the previous year was the strongest predictor of ICS/LABA prescribing in the COPD patients who were not registered with a concomitant diagnosis of asthma (OR 3.2, 95% CI 1.0-10.0) but this association was limited to the patients with severe disease (FEV1% predicted <50) (OR 13.5, 95% CI 1.8-101.1). Cardiovascular disease was associated with decreased ICS/LABA prescribing (OR 0.4, 95% CI 0.2-0.8) in the COPD group. A Kappa coefficient of 0.32 was found between the actual prescribing rate and that recommended in the 2007 GOLD guidelines.
conclusionsOverprescribing of ICS/LABA for the COPD patients was shown. Previous exacerbation was a strong predictor of ICS/LABA prescribing only in patients with severe COPD. Because of the low emphasis on previous exacerbation when prescribing for COPD patients with mild to moderate disease, the actual prescribing rate agreed more closely with the GOLD guidelines from 2007 than with those published in 2011. Cardiovascular disease was associated with decreased prescribing, indicating that GPs adjust the treatment in cases with multimorbidity.
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