Individualizing the selection of long-acting bronchodilator therapy for patients with COPD: considerations in primary care

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a common condition encountered in primary care settings. COPD remains the third leading cause of death in the United States and carries a significant burden to both patients and the healthcare system. COPD is a chronic, progressive, irreversible lung disease associated with high morbidity and mortality. Proper assessment and diagnosis requires spirometry which is currently underutilized in primary care. Management is focused on adequate symptom control, improving quality of breathing and quality of life, and preventing exacerbations and hospitalizations. However, many patients are not receiving long-acting bronchodilator maintenance therapy as recommended in current clinical guidelines. Even when patients receive appropriate therapy, real-world issues such as a patient’s health literacy, physical and cognitive limitations, and therapy nonadherence limit the effectiveness of prescribed inhaled medications. Primary care providers are well situated to ensure that prescribed therapies and long-term management goals are matched to the individual needs of patients with COPD.

KEYWORDS:

• COPD
• COPD exacerbations
• primary care
• spirometry
• device selection
• LABA/LAMA therapy
• nebulized LABA therapy

Declaration of interest

The authors were not remunerated for the development of this manuscript and retained full control of its content as well as its final approval. The authors have the following additional disclosures: BW Carlin reports serving as an advisor to AstraZeneca, Monaghan Medical, Nonin, Philips Respironics, and Sunovion Pharmaceuticals. BW Carlin also reports receiving lecture fees from Boehringer Ingelheim, Monaghan Medical, and Sunovion Pharmaceuticals; SK Schuldheisz and I Noth report serving as an advisor to Sunovion Pharmaceuticals; and GJ Criner reports receiving research support from Aeris, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Pearl, PneumRx, Pulmonx, and Philips Respironics. GJ Criner also reports serving as an advisor to Sunovion Pharmaceuticals and receiving lecture fees from AstraZeneca, Boehringer Ingelheim, Johnson & Johnson, and Respivert. Medical writing and editorial support was provided by Sean M. Gregory, PhD, Hybrid Healthcare Communications, LLC. Funding for medical writing and editorial support was provided by Sunovion Pharmaceuticals, Inc. The sponsor had no role in the development or approval of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

Funding for medical writing and editorial support was provided by Sunovion Pharmaceuticals, Inc.

Notes on contributors

Brian W. Carlin

BW Carlin: outline, first draft, final approval; SK Schuldheisz, I Noth, and GJ Criner: critical review and revision of the manuscript, final approval.