부산대학교 도서관

Purpose: There is a high prevalence of chronic obstructive pulmonary disease (COPD) in the United States (US). Although guidelines are available for the treatment of COPD, evidence suggests that management of COPD in clinical practice is not always aligned with this guidance. This study aimed to further understand the current use of COPD maintenance medication in the US. Patients and Methods: This study was an analysis of data from the Adelphi Respiratory Disease Specific Programme (DSP[TM]) 2019. Point-in-time data were collected from participating US physicians and their COPD patients. Physicians were either primary care physicians (PCPs) or pulmonologists, with a minimum workload of [greater than or equal to] 3 COPD patients per month. Patients were aged [greater than or equal to] 18 years with a physician-confirmed diagnosis of COPD. Results: In total, 171 physicians completed the survey (92 PCPs and 79 pulmonologists). Mean patient age was 66.4 years, 45% were female, with moderate COPD in 49.4% of patients and severe/very severe in 19.3%. Pulmonologists more frequently prescribed dual bronchodilation and triple therapy than PCPs, whereas inhaled corticosteroid/long-acting [[beta].sub.2]-agonist was more frequently prescribed by PCPs than pulmonologists. For both physician types, the most common reason for prescribing their patients' current treatment was 24-hour symptom relief. The majority of PCPs (70.1%) and pulmonologists (71.9%) reported referring to COPD guidelines when making treatment decisions. Conclusion: Prescribing patterns for COPD patients were found to differ between PCPs and pulmonologists. Improved physician understanding of how to tailor treatment for each patient, based on current symptoms and exacerbation risk, could help optimize patient care in COPD. Keywords: COPD, inhaled corticosteroids, long-acting [[beta].sub.2]-agonist, long-acting muscarinic antagonist, maintenance therapy, survey Plain Language Summary Patients with COPD are usually treated by a primary care physician (PCP) and/or a specialist doctor (pulmonologist). These doctors typically follow guideline recommendations on how to choose the best treatment based on symptoms and frequency/severity of exacerbations experienced by each of their patients with COPD. We designed a study using data from a survey completed by pulmonologists and PCPs to understand what COPD treatments they prescribe and whether they follow guidelines when selecting treatments for their patients. In total, 171 doctors completed the survey (92 PCPs and 79 pulmonologists) and provided anonymous information about 800 of their patients with COPD. The survey showed that patients treated by pulmonologists are more often prescribed combination treatments that have more recently been introduced and are now recommended by guidelines. Patients being treated by PCPs are more often prescribed an inhaled corticosteroid combined with a long-acting bronchodilator, irrespective of the patients' current COPD symptoms and risk of having an exacerbation. Both types of doctor indicated that their most common reason for prescribing a treatment was to provide patients with 24-hour symptom relief. Most PCPs (70.1%) and pulmonologists (71.9%) reported referring to COPD guidelines when deciding on a treatment for their patients. The study results suggest that some doctors may not follow guideline recommendations exactly when personalizing treatment regimens for patients with COPD. Personalizing the medication choice to properly treat each patient is important, and these guidelines can help doctors choose the best treatment that will control COPD and improve patients' daily lives.
Introduction Despite the availability of international and national treatment guidelines for chronic obstructive pulmonary disease (COPD), evidence suggests that available therapies may not be utilized to their full potential to [...]