| Complexity of Medication Use in Newly Diagnosed Chronic Obstructive Pulmonary Disease Patients. | |
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MedLine Citation:
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PMID: 22280978 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: To better understand how medications have been used and the complexity of regimens used to treat patients, we characterized patterns of medication use and the degree to which patients used different classes of medications in combination and over time in a cohort of newly diagnosed chronic obstructive pulmonary disease (COPD) patients. OBJECTIVE: The objectives of this study were to characterize patterns of medication use, including the degree to which patients used different classes of medications in combination and over time within a cohort of newly diagnosed COPD patients and to identify the proportion of patients who had gaps in filling their prescriptions. METHODS: We identified a cohort of patients from the Veterans Affairs health care system with newly diagnosed COPD between 1999 and 2003. Using prescription fill information, we quantified the prevalence and incidence of exposure to short-acting β-agonists (SABAs), long-acting β-agonists (LABAs), short-acting anticholinergics (eg, ipratropium [IPRA]), and inhaled corticosteroids (ICSs) over 1 year. We additionally characterized the sequencing of medication addition and discontinuation and gaps between prescription fills. The prevalence of multiple respiratory medication use was summarized at 90, 180, and 365 days of follow-up. RESULTS: Of 133,737 patients with newly diagnosed COPD, the majority (80.0%) used a SABA, followed by 40.0% using IPRA, 33.2% using an ICS and 16.0% using a LABA during the 1-year follow-up. Medication changes were frequent, with 57.7% of patients having a medication addition and 48.6% discontinuing medication. The sequence of medication changes varied greatly across patients. Multiple respiratory medication use was common, with 29% of patients dispensed 3 to 4 medication classes in 1 year. CONCLUSIONS: Many COPD patients who are started on medication management undergo changes in prescribed pharmacotherapy and are taking multiple medications. Despite clinical practice guidelines, there is an ad hoc nature of COPD medication management, and such heterogeneity challenges the ability to estimate relationships between drug exposure and outcomes using real-world data. |
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Authors:
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Caitlyn T Solem; Todd A Lee; Min J Joo; Bruce L Lambert; Surrey M Walton; A Simon Pickard |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-24 |
Journal Detail:
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Title: The American journal of geriatric pharmacotherapy Volume: - ISSN: 1876-7761 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101190325 Medline TA: Am J Geriatr Pharmacother Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved. |
Affiliation:
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Center for Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois; Department of Pharmacy Administration, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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