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International Journal of Chronic Obstructive Pulmonary Disease Volume 10, 2015 - Issue
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Original Research

The inevitable drift to triple therapy in COPD: an analysis of prescribing pathways in the UK

Guy Brusselle1 Department of Respiratory Medicine, University Hospital Ghent, Ghent, Belgium;2 Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands;3 Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, Netherlands
,
David Price4 Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK;5 Research in Real Life (RiRL), SingaporeCorrespondence[email protected]
,
Kevin Gruffydd-Jones6 Box Surgery, Wiltshire, UK
,
Marc Miravitlles7 Pneumology Department, Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
,
Dorothy L Keininger8 Novartis Pharma AG, Basel, Switzerland
,
Rebecca Stewart5 Research in Real Life (RiRL), Singapore
,
Michael Baldwin9 Novartis Pharmaceuticals Limited, Horsham, UK
&
Rupert C Jones10 Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
 show all
Pages 2207-2217 | Published online: 15 Oct 2015

Figures & data

Figure 1 Patient selection.

Abbreviations: GOLD, Global initiative for chronic Obstructive Lung Disease; OPCRD, Optimum Patient Care Research Database; QOF, quality and outcomes framework.
Figure 1 Patient selection.

Table 1 Summary of patient characteristics at time of diagnosis

Table 2 Triple therapy status by GOLD group (2002–2010)

Figure 2 Cumulative proportion of patients receiving triple therapy by GOLD group (2002–2010).

Note: P=0.065 (chi-square test).
Abbreviation: GOLD, Global initiative for chronic Obstructive Lung Disease.
Figure 2 Cumulative proportion of patients receiving triple therapy by GOLD group (2002–2010).

Figure 3 Distribution of different treatment pathways leading to triple therapy (ICS plus LABA plus LAMA), identified from total triple therapy population (n=3,505).

Notes: Pathways with a percent frequency of less than 1% were grouped under the category “other non-frequent pathways”. The first drug listing in the treatment pathway was considered to be the patient’s initial therapy, and the second drug listing was the prescription after the initial date of COPD diagnosis.

Abbreviations: ICS, inhaled corticosteroid; LABA, long-acting β2-agonist; LAMA, long-acting muscarinic antagonist; SABA, short-acting β2-agonist; SAMA, short-acting muscarinic antagonist.
Figure 3 Distribution of different treatment pathways leading to triple therapy (ICS plus LABA plus LAMA), identified from total triple therapy population (n=3,505).Notes: Pathways with a percent frequency of less than 1% were grouped under the category “other non-frequent pathways”. The first drug listing in the treatment pathway was considered to be the patient’s initial therapy, and the second drug listing was the prescription after the initial date of COPD diagnosis.

Table 3 Pathways to triple therapy split by mMRC score

Table 4 Pathways to triple therapy split by exacerbation history

Table 5 Pathways to triple therapy split by lung function grade

 

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