Journal article
Alignment of Inhaled Chronic Obstructive Pulmonary Disease Therapies with Published Strategies. Analysis of the Global Initiative for Chronic Obstructive Lung Disease Recommendations in SPIROMICS
Annals of the American Thoracic Society, Vol.16(2), pp.200-208
02/2019
DOI: 10.1513/AnnalsATS.201804-283OC
PMCID: PMC6376942
PMID: 30216731
Abstract
Despite awareness of chronic obstructive pulmonary disease (COPD) treatment recommendations, uptake is poor. The Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) spans 2010-2016, providing an opportunity to assess integration of 2011 Global Initiative for Obstructive Lung Disease (GOLD) treatment strategies over time in a large observational cohort study.
To evaluate how COPD treatment aligns with 2011 GOLD strategies and determine factors associated with failure to align with recommendations.
Information on inhaled medication use collected via questionnaire annually for 4 years was compiled into therapeutic classes (long-acting antimuscarinic agent, long-acting β-agonist, inhaled corticosteroids [ICS], and combinations thereof). Medications were not modified by SPIROMICS investigators. 2011 GOLD COPD categories A, B, C, and D were assigned. Alignment of inhaler regimen with first-/second-line GOLD recommendations was determined, stratifying into recommendation aligned or nonaligned. Recommendation-nonaligned participants were further stratified into overuse and underuse categories.
Of 1,721 participants with COPD, at baseline, 52% of regimens aligned with GOLD recommendations. Among participants with nonaligned regimens, 46% reported underuse, predominately owing to lack of long-acting inhalers in GOLD category D. Of the 54% reporting overuse, 95% were treated with nonindicated ICS-containing regimens. Among 431 participants with 4 years of follow-up data, recommendation alignment did not change over time. When we compared 2011 and 2017 recommendations, we found that 47% did not align with either set of recommendations, whereas 35% were in alignment with both recommendations.
Among SPIROMICS participants with COPD, nearly 50% reported inhaler regimens that did not align with GOLD recommendations. Nonalignment was driven largely by overuse of ICS regimens in milder disease and lack of long-acting inhalers in severe disease.
Details
- Title: Subtitle
- Alignment of Inhaled Chronic Obstructive Pulmonary Disease Therapies with Published Strategies. Analysis of the Global Initiative for Chronic Obstructive Lung Disease Recommendations in SPIROMICS
- Creators
- Sohini Ghosh - KTU Faculty of MedicineWayne H Anderson - University of North Carolina at Chapel HillNirupama Putcha - Johns Hopkins UniversityMeilan K Han - University of Michigan–Ann ArborJeffrey L Curtis - University of Michigan–Ann ArborGerard J Criner - Temple UniversityMark T Dransfield - University of Alabama at BirminghamR Graham Barr - Columbia University Irving Medical CenterJerry A Krishnan - University of Illinois at ChicagoStephen C Lazarus - University of California, San FranciscoChristopher B Cooper - University of California, Los AngelesRobert Paine III - University of UtahStephen P Peters - Atrium Health Wake Forest BaptistNadia N Hansel - Johns Hopkins UniversityFernando J Martinez - Weill Cornell MedicineM Bradley Drummond - 1 Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, andSubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Investigators
- Contributors
- Eric A Hoffman (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.16(2), pp.200-208
- DOI
- 10.1513/AnnalsATS.201804-283OC
- PMID
- 30216731
- PMCID
- PMC6376942
- ISSN
- 2325-6621
- eISSN
- 2325-6621
- Grant note
- HHSN268200900017C / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS HHSN268200900019C / NHLBI NIH HHS HHSN268200900020C / NHLBI NIH HHS U24 HL141762 / NHLBI NIH HHS U01 HL137880 / NHLBI NIH HHS HHSN268200900015C / NHLBI NIH HHS HHSN268200900013C / NHLBI NIH HHS I01 CX000911 / CSRD VA K24 HL137013 / NHLBI NIH HHS HHSN268200900016C / NHLBI NIH HHS T32 HL007106 / NHLBI NIH HHS R01 HL125432 / NHLBI NIH HHS HHSN268200900018C / NHLBI NIH HHS HHSN268200900014C / NHLBI NIH HHS K23 HL130627 / NHLBI NIH HHS K24 HL138188 / NHLBI NIH HHS K23 HL123594 / NHLBI NIH HHS
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318685802771
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