| アブストラクト | Purpose: Treatment pathways of patients with chronic obstructive pulmonary disease (COPD) receiving single-inhaler dual therapies remain unclear. We aimed to describe characteristics, prescribed treatments, healthcare resource use (HCRU) and costs of patients with COPD who initiated single-inhaler long-acting muscarinic antagonist/long-acting beta2-agonist (LAMA/LABA) dual therapy in primary care in England. Patients and Methods: Retrospective study using linked data from Clinical Practice Research Datalink Aurum and Hospital Episode Statistics datasets. Patients with COPD with >/=1 single-inhaler LAMA/LABA prescription between June 2015 and December 2018 (index) were included. Demographic and clinical characteristics, prescribed treatments, HCRU and costs were evaluated in the 12 months pre-index. Data are presented for patients not receiving concomitant inhaled corticosteroids at index (non-triple users). Results: Of 10,991 patients initiating LAMA/LABA, 9888 were non-triple users, of whom 21.3% (n=2109) received aclidinium bromide/formoterol, 18.1% (n=1785) received indacaterol/glycopyrronium, 12.0% (n=1189) received tiotropium bromide/olodaterol and 48.6% (n=4805) received umeclidinium/vilanterol. Demographic and clinical characteristics were similar across indexed therapies. LAMA monotherapy was the most frequently prescribed respiratory therapy at 12 (18.4-25.8% of patients) and 3 months (23.9-33.7% of patients) pre-index across indexed therapies; 42.5-59.0% of patients were prescribed no respiratory therapy at these time points. COPD-related HCRU during the 12 months pre-index was similar across indexed therapies (general practitioner consultations: 62.0-68.6% patients; inpatient stays: 19.3-26.1% patients). Pre-index COPD-related costs were similar across indexed therapies, with inpatient stays representing the highest contribution. Mean total direct annual COPD-related costs ranged from pound805- pound1187. Conclusion: Characteristics of patients newly initiating single-inhaler LAMA/LABA dual therapy were highly consistent across indexed therapies. As half of non-triple users were not receiving respiratory therapy one year prior to LAMA/LABA initiation, there may be an opportunity for early optimization of treatment to relieve clinical burden versus current prescribing patterns in primary care in England. |
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| ジャーナル名 | International journal of chronic obstructive pulmonary disease |
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| 投稿日 | 2022/8/20 |
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| 投稿者 | Requena, Gema; Banks, Victoria; Czira, Alexandrosz; Wood, Robert; Tritton, Theo; Wild, Rosie; Compton, Chris; Duarte, Maria; Ismaila, Afisi S |
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| 組織名 | Value Evidence and Outcomes, Epidemiology, GSK, R&D Global Medical, Brentford,;Middlesex, UK.;Real-world Evidence, Adelphi Real World, Bollington, Cheshire, UK.;Value Evidence and Outcomes, GSK, Collegeville, PA, USA.;Department of Health Research Methods, Evidence and Impact, McMaster University,;Hamilton, ON, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35983168/ |
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