Are COPD Prescription Patterns Aligned with Guidelines? Evidence from a Canadian Population-Based Study

Figures & data

Table 1 Characteristics of Patients and the Visits in the Cohort

Patient Characteristics at Index Date	Study Cohort (n=132,004)
Female sex (%) ^a	64,942 (49.2)
Age (SD)	68.6 (12.5)
Years from COPD diagnosis	5.4 (3.5)
Socioeconomic status (%)
Quantile 1	34,699 (26.3%)
Quantile 2	28,116 (21.3%)
Quantile 3	24,630 (18.7%)
Quantile 4	22,500 (17.1%)
Quantile 5	19,545 (14.8%)
Unknown	2,514 (1.9%)
Visit Characteristics for the Sub-Cohort of COPD Patients Alive in 2010	Visits Followed by Prescription (n=260,164)
Patient was frequent exacerbator in the previous 12 months	79,820 (30.7%)
History of PFT before visit	228,464 (87.8%)
History of asthma diagnosis before visits	142,457 (54.8%)
COPD-related medications in the three months before the visit
ICS only	28,624 (11.0%)
LABA only	2,039 (0.78%)
LAMA only	18,414 (7.08%)
LAMA+LABA	2,086 (0.8%)
ICS+LABA	80,205 (30.83%)
ICS+LAMA	4,861 (1.87%)
ICS+LAMA+LABA	71,152 (27.35%)

Note: ^aNumber of patients (and percent of cohort) are reported unless otherwise indicated.

Abbreviations: COPD, chronic obstructive pulmonary disease; PFT, pulmonary function test; ICS, inhaled corticosteroids; LABA, long-acting beta-2 adrenoceptor agonists; LAMA, long-acting muscarinic receptor antagonists.

Figure 1 Trends in the proportion of patients filling at least one prescription (A) and average dose-adjusted number of canisters (B) for major COPD inhaled therapies, during disease course.

Abbreviations: ICS, inhaled corticosteroids; LABA, long-acting beta-2 adrenoceptor agonists; LAMA, long-acting muscarinic receptor antagonists.

Figure 2 Trends in the proportion of patients on combination therapies (A) and average medication possession ratio (B) over the time course of COPD.

Abbreviations: ICS, inhaled corticosteroids; LABA, long-acting beta-2 adrenoceptor agonists; LAMA, long-acting muscarinic agents; ICS/LABA/LAMA, triple therapy.

Figure 3 Frequency of long-acting inhaled medication prescription in frequent (dark bars) and non-frequent (light bars) exacerbators.

Abbreviations: ICS, inhaled corticosteroids; LABA, long-acting beta-2 adrenoceptor agonists; LAMA, long-acting muscarinic receptor antagonists.

Figure 4 Forest plot of odds ratio (OR) and 95% confidence interval between frequent-exacerbator status and filled prescriptions for each medication type, separately for GP and specialist compared to non-frequent exacerbators.

Abbreviations: ICS, inhaled corticosteroids; LABA, long-acting beta-2 adrenoceptor agonists; LAMA, long-acting muscarinic receptor antagonists; GP, general practitioner.