Observational studyNPJ primary care respiratory medicine2016
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.
Observational study in NPJ primary care respiratory medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Inhaled corticosteroids and FEVRespiratory research · 2019Pooled it
- Long-term cardiovascular risk after severe exacerbation of COPD: a population-based cohort study.ERJ open research · 2026Article
- Pragmatic Evaluation of an Improvement Program for People Living With Modifiable High-Risk COPD Versus Usual Care: Protocols for the Cluster Randomized PREVAIL Trial.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025Article
- Rational use of inhaled corticosteroids for the treatment of COPD.NPJ primary care respiratory medicine · 2023Review
- Prescription Patterns of New Use of Fixed-Dose Combination Inhalers in Patients with Chronic Obstructive Pulmonary Disease: Long-Acting β2 Agonists Plus Long-Acting Muscarinic Antagonists versus Long-Acting β2 Agonists Plus Inhaled Corticosteroids.International journal of chronic obstructive pulmonary disease · 2023Article
- LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations.Journal of clinical medicine · 2022Review
- Characterisation of patients with chronic obstructive pulmonary disease initiating single-device inhaled corticosteroids/long-acting βBMJ open respiratory research · 2022Article
- Treatment Patterns for Chronic Obstructive Pulmonary Disease (COPD) in the United States: Results from an Observational Cross-Sectional Physician and Patient Survey.International journal of chronic obstructive pulmonary disease · 2022Article
- Association Between Adherence to Maintenance Medication in Patients with COPD and Acute Exacerbation Occurrence and Cost in China: A Retrospective Cohort Database Study.International journal of chronic obstructive pulmonary disease · 2020Article
- Adequacy of Therapy for People with Both COPD and Heart Failure in the UK: Historical Cohort Study.Pragmatic and observational research · 2020Article
- Inhaled corticosteroids in COPD and onset of type 2 diabetes and osteoporosis: matched cohort study.NPJ primary care respiratory medicine · 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
- Population-based study of LAMA monotherapy effectiveness compared with LABA/LAMA as initial treatment for COPD in primary care.NPJ primary care respiratory medicine · 2018Article
- Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care.BMC medical research methodology · 2018Article
- Observational
- Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit.International journal of chronic obstructive pulmonary disease · 2018Observational
- Determinants of initial inhaled corticosteroid use in patients with GOLD A/B COPD: a retrospective study of UK general practice.NPJ primary care respiratory medicine · 2017Article
- Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort.European clinical respiratory journal · 2017Article
- Factors influencing pharmacological treatment in COPD: a comparison of 2005 and 2014.European clinical respiratory journal · 2017Article
- Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD: results from a national database.International journal of chronic obstructive pulmonary disease · 2016Observational
Corrections and comments
- Erratum issued
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prescribing patterns in chronic obstructive pulmonary disease (COPD) are often inconsistent with published guidelines. This retrospective, observational study utilised data from the Optimum Patient Care Research Database to examine the changes in COPD prescribing patterns over time and to identify predictors of physician treatment choice for patients newly diagnosed with COPD. Initial therapy was defined as the treatment(s) prescribed at or within 1 year before COPD diagnosis. Changes over time were assessed in three cohorts based on the date of diagnosis: (1) 1997-2001; (2) 2002-2006; and (3) 2007-2010. Factors affecting the odds of being prescribed any initial therapy or any initial maintenance therapy were identified by univariable and multivariable logistic regression. The analysis included 20,154 patients, 45% of whom were prescribed an initial regimen containing an inhaled corticosteroid (ICS), whereas 28% received no initial pharmacological treatment. Prescribing of ICS monotherapy decreased over time, as did the proportion of patients receiving no therapy at or within 1 year before diagnosis. Comorbid asthma, a high exacerbation rate, increased symptoms and poor lung function each increased the likelihood of being prescribed any initial therapy or initial maintenance therapy; comorbid asthma and an annual rate of ⩾3 exacerbations were the strongest predictors. In conclusion, our analyses revealed major differences between actual prescribing behaviour and guideline recommendations for patients with newly diagnosed COPD, with many patients receiving no treatment and large numbers of patients receiving ICS-containing regimens. Predictors of initial therapy were identified.
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