Observational studyAnnals of the American Thoracic Society2019
Alignment of Inhaled Chronic Obstructive Pulmonary Disease Therapies with Published Strategies. Analysis of the Global Initiative for Chronic Obstructive Lung Disease Recommendations in SPIROMICS.
Observational study in Annals of the American Thoracic Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01969344 (Subpopulations and Intermediate Outcome Measures in COPD Study), which is not on this map. Cited by 30 papers.
What it found
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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.
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.
Subpopulations and Intermediate Outcome Measures in COPD Study
Who cites it
30 citing papers in PubMed, 40 citations in OpenAlex.
- Trial
- Article
- Guideline-concordant inhaled medication use in COPD: a systematic review of definitions used in administrative health data.ERJ open research · 2025Article
- 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
- Patterns of care in the management of high-risk COPD in Australia (2015-2019): an observational study for the CONQUEST quality improvement program.The Lancet regional health. Western Pacific · 2025Article
- How Does Disease Severity Affect Clinical Outcomes and Economic Burden of Patients with COPD -- A Retrospective Population-Based Cohort Study in Tianjin, China.International journal of chronic obstructive pulmonary disease · 2025Article
- Guideline Alignment and Medication Concordance in COPD.CHEST pulmonary · 2024Article
- Guideline-discordant inhaler regimens after COPD hospitalization: associations with rurality, drive time to care, and fragmented care - a United States cohort study.Lancet regional health. Americas · 2023Article
- Clinical and economic outcomes in patients with chronic obstructive pulmonary disease initiating maintenance therapy with tiotropium bromide/olodaterol or fluticasone furoate/umeclidinium/vilanterol.Journal of managed care & specialty pharmacy · 2023Observational
- Trends and Rural-Urban Differences in the Initial Prescription of Low-Value Inhaled Corticosteroids among U.S. Veterans with Chronic Obstructive Pulmonary Disease.Annals of the American Thoracic Society · 2023Article
- Persistent Steroid Exposure Before Coronavirus Disease 2019 Diagnosis and Risk of Hospitalization in Patients With Chronic Obstructive Pulmonary Disease.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2023Article
- Trends and Characteristics of Global Initiative for Chronic Obstructive Lung Disease Guidelines-Discordant Prescribing of Triple Therapy Among Patients with COPD.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Review
- Trends in non-receipt of recommended COPD medication.ERJ open research · 2022Article
- Association of Patient and Primary Care Provider Factors with Outpatient COPD Care Quality.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Article
- Use of single-inhaler triple therapy in the management of obstructive airway disease: Indian medical experts' review.ERJ open research · 2022Review
- Effect of Respiration Training-Assisted Western Medicine Therapy on Activity Tolerance, Pulmonary Function, and Quality of Life of Chronic Obstructive Pulmonary Disease Patients in the Stable Phase.Journal of healthcare engineering · 2022Article
- Article
- Self-reported COPD Medication Use and Adherence in the COPD Foundation Patient- Powered Registry Network.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2021Article
- The clinical impact of adherence to therapy in airways disease.Breathe (Sheffield, England) · 2021Review
- Low-Value Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease and the Association with Healthcare Utilization and Costs.Annals of the American Thoracic Society · 2021Article
Corrections and comments
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Authors and funding
17 authors at 13 institutions in 1 country.
Funding
Abstract
rationaleDespite awareness of chronic obstructive pulmonary disease (COPD) treatment recommendations, uptake is poor. The Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) spans 2010-2016, providing an opportunity to assess integration of 2011 Global Initiative for Obstructive Lung Disease (GOLD) treatment strategies over time in a large observational cohort study.
objectivesTo evaluate how COPD treatment aligns with 2011 GOLD strategies and determine factors associated with failure to align with recommendations.
methodsInformation on inhaled medication use collected via questionnaire annually for 4 years was compiled into therapeutic classes (long-acting antimuscarinic agent, long-acting β-agonist, inhaled corticosteroids [ICS], and combinations thereof). Medications were not modified by SPIROMICS investigators. 2011 GOLD COPD categories A, B, C, and D were assigned. Alignment of inhaler regimen with first-/second-line GOLD recommendations was determined, stratifying into recommendation aligned or nonaligned. Recommendation-nonaligned participants were further stratified into overuse and underuse categories.
resultsOf 1,721 participants with COPD, at baseline, 52% of regimens aligned with GOLD recommendations. Among participants with nonaligned regimens, 46% reported underuse, predominately owing to lack of long-acting inhalers in GOLD category D. Of the 54% reporting overuse, 95% were treated with nonindicated ICS-containing regimens. Among 431 participants with 4 years of follow-up data, recommendation alignment did not change over time. When we compared 2011 and 2017 recommendations, we found that 47% did not align with either set of recommendations, whereas 35% were in alignment with both recommendations.
conclusionsAmong SPIROMICS participants with COPD, nearly 50% reported inhaler regimens that did not align with GOLD recommendations. Nonalignment was driven largely by overuse of ICS regimens in milder disease and lack of long-acting inhalers in severe disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.