Background and aims: Short-acting bronchodilators are normally used as supplemental relief medication for breakthrough symptoms in COPD patients. The objective of this cross-sectional study was to assess if more frequent vs infrequent use of relief medication in maintenance-treated COPD patients, split by the severity dyspnea, was associated with an increase in the overall disease burden.Methods: A population-based cross-sectional survey (Adelphi DSP) was conducted among patients with COPD in five European countries. Information was collected on demographic and clinical characteristics, reliever inhaler use, dyspnea (mMRC), health status (CAT, EQ-5D), sleep quality (JSEQ) and healthcare resource use including moderate–severe COPD exacerbations, physician visits, COPD medications and other COPD related resources. The humanistic and economic burden was compared between patients with infrequent reliever use (<1 occasion/week) and more frequent use (≥ 1 occasion/week). The association between increase...

https://www.tandfonline.com/doi/pdf/10.1080/13696998.2016.1223085

Bronchodilator reliever use and its association with the economic and humanistic burden of COPD: a propensity-matched study

Introduction and objectives National Institute for Health and Care Excellence (NICE) recommends long–acting bronchodilators, including β2-agonists (LABAs) or muscarinic antagonists (LAMAs) as first line maintenance treatment for patients with COPD. The aim of this descriptive study was to characterise a cohort of COPD patients who were on maintenance bronchodilator monotherapy for at least six months to establish their disease burden, measured by healthcare utilisation. Methods Data were extracted from the UK Clinical Practice Research Datalink (CPRD) which also linked to Hospital Episode Statistics (HES). The monotherapy period spanned the first prescription of a LABA or LAMA until the end of the study period (31/12/2013) or until step-up to dual/triple therapy; for example the addition of another long acting bronchodilator, an ICS or ICS/LABA. A minimum of four consecutive prescriptions and six months on continuous monotherapy were required for study entry. Patients Results A cohort of 8,811 COPD patients (94% GOLD stage A or B) on maintenance monotherapy was identified between 2002 and 2013; 45% (N=3,947) of these patients were still on monotherapy by the end of the study period. The median time from first COPD diagnosis to first monotherapy prescription was 56 days while the median time on maintenance bronchodilator monotherapy was 748 days. The median number of prescriptions during this period was 14. Patients had a median of 19 HCP consultations and a mean of 0.1 (95% CI 0.1, 0.2, N= 8,811) COPD exacerbations and 0.02 (95% CI 0.01, 0.02, N=4,848) COPD hospitalisations per year. Conclusion In summary, COPD patients who are on maintenance bronchodilator monotherapy for at least six months appear to remain on this therapy for over two years despite having a disease burden that requires healthcare resources, particularly HCP consultations, at a cost to the NHS.

https://thorax.bmj.com/content/thoraxjnl/69/Suppl_2/A186.1.full.pdf

P248 Current Copd Disease Burden Associated With Maintenance Monotherapy In The Uk

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P248 Current Copd Disease Burden Associated With Maintenance Monotherapy In The Uk