Patterns of use of long‐acting bronchodilators in patients with COPD: A nationwide follow‐up study of new users in New Zealand

• DOI: 10.1111/resp.13235
• Publication Date: 2017-12-18T19:46:21Z
• Authors: Lianne Parkin; David Barson; Jiaxu Zeng; Simon Horsburgh; Katrina Sharples; Jack Dummer
• Keywords: Lama; Regimen; Muscarinic antagonist

ABSTRACT Background and objective While several studies have found that prescribing practices do not conform to chronic obstructive pulmonary disease (COPD) treatment guidelines, none examined longitudinal patterns of use long‐acting beta 2 ‐agonist (LABA) muscarinic antagonist (LAMA) therapy across an entire country. We undertook a nationwide follow‐up study describe in new users bronchodilators. Methods National health pharmaceutical dispensing data were used identify patients aged ≥45 years who initiated LABA and/or LAMA for COPD between 1 February 2006 31 December 2013. Dispensings LABAs, LAMAs inhaled corticosteroids (ICSs) aggregated into episodes therapeutic regimens. Kaplan–Meier curves, sunburst plots sequence index generated summarize, respectively, the duration first regimen, sequences which unique regimens non‐use during follow‐up. Results The cohort included 83 435 with 290 400 person‐years most commonly regimen was ICS. ICS inconsistent international guidelines: over‐ under‐treatment occurred infrequent frequent exacerbations, monotherapy common. median 46 days. Many multiple over time periods Conclusion In this study, ICSs complex often did comply guidelines. Further work is required address discrepancy guidelines practices.