Title: COPD Patients Overuse Prescription Drugs, Ignoring GOLD Guidelines
In a concerning trend, a new study reveals that patients with Chronic Obstructive Pulmonary Disease (COPD) are overusing prescription drugs, disregarding the evidence-based guidelines established by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Particularly, the excessive usage of inhaled corticosteroids (ICS) remains a persistent challenge in COPD management.
This real-world study retrospectively analyzed the medical charts of 2291 patients diagnosed with COPD, out of which 1438 fulfilled the eligibility criteria. The findings shed light on the adherence to the GOLD treatment recommendations, the rate of ICS usage, and the prescription rates of triple therapy (TT).
The average age of the patients was 69.6 years, with 52% being female. The patients had an average COPD assessment test (CAT) score of 18.3. Classification of patients based on the 2017 GOLD guidelines revealed that 19.5% belonged to group A, 64.1% to group B, 1.8% to group C, and 14.6% to group D. Shockingly, all groups, except group D, showed noncompliance with COPD treatment as suggested by the GOLD guidelines.
To further elaborate, only 18.9% of patients in group A and 26% in group B received treatment in accordance with the guidelines. Triple therapy (TT) was primarily prescribed to patients in group D (63.3%), but it was also overused in groups A (30.6%) and B (47.8%). Inhaled corticosteroids (ICS) were overused across all groups, with alarming rates of 56.2% in group A and 67.3% in group B.
These findings raise concerns regarding the lack of conformity between physician prescribing practices and the GOLD guidelines, a recurring trend observed over the past decade. Notably, the excessive use of ICS despite known adverse effects and associated costs is particularly troubling. It is evident that there is a pressing need to enhance the awareness and knowledge of GOLD guidelines among primary care physicians (PCPs) and respiratory specialists.
Chronic obstructive pulmonary disease (COPD) is a progressive and inflammatory ailment characterized by airflow restriction and irreversible damage to lung function. It is becoming increasingly prevalent worldwide due to the aging population. In the United States alone, approximately 16 million cases of COPD have been reported, making it the country’s third leading cause of death. The economic impact of COPD is significant, with per-patient direct medical costs averaging $10,367 annually, and hospitalization costs averaging $6852. In 2010, COPD care accounted for a total annual expenditure of $6.6 billion, with prescription drug costs amounting to a staggering $472 billion.
The Global Initiative for Obstructive Lung Disease (GOLD) science committee has published and promoted evidence-based guidelines to aid in COPD management. However, the overuse of prescription drugs, especially inhaled corticosteroids (ICS) across all stages of COPD, remains a persistent challenge. Excessive medication usage significantly contributes to the rising costs associated with COPD management. While smoking cessation and reducing COPD exacerbations help control expenses, appropriate inhaler use among COPD patients would also contribute to cost reduction. Primary care physicians (PCPs) are often accused of overprescribing ICS, but this prescription pattern extends beyond them. A study conducted in Canada’s respiratory department revealed that 26.8% of patients in GOLD group A and 42.6% in GOLD group B received triple therapy (TT).
The objectives of this study were to understand the distribution of COPD in a nonacademic pulmonary specialty practice and assess adherence to the COPD GOLD 2017 recommendations.
In conclusion, the study highlights the concerning trend of COPD patients overusing prescription drugs, disregarding the GOLD guidelines. The overutilization of inhaled corticosteroids (ICS) poses serious health risks and financial burdens. Efforts to improve the awareness and understanding of GOLD guidelines among healthcare providers, including primary care physicians and respiratory specialists, are imperative. Striving for adherence to evidence-based guidelines will not only enhance patient care but also alleviate the economic impact of COPD management.
