SESSION TITLE: COPD Treatment
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, October 26, 2014 at 01:30 PM - 03:00 PM
PURPOSE: GOLD proposed a COPD assessment framework focused on symptoms measured by validated questionaires such as the COPD Assessment Test (CAT) or the mMRC, on degree of airflow limitation(Post bronchodilator FEV1 <50%), or a history of ≥2 exacerbations. In the GOLD assesment of COPD, patients are categorized in an A,B,C and D. This combined assesment is used to improve COPD management. The purpose of this prospective study was to examine the characteristics of COPD patients recruited from routine clinical settings. Patients were classified using the GOLD framework in order to assess the most common treatment options prescribed as well as the comorbidities.
METHODS: The data of the patients who were admitted to the oupatients clinics of COPD were assessed retrospectively between June-December 2013.
RESULTS: 114 COPD patients (17 female) were classified in A,B,C, and D categories according to the assessment of CAT, mMRC, spirometry and exacerbation history in the previous year. Their mean age was 67.06±7.97 years and mean FEV1 was 62.5± 17.8% predicted. In 65.8% of the patients the mMRC was ≥ 2 or the CAT was found to be ≥ 10. The results using the CAT or the mMRC were 26.3% in Group A, 40.4% in Group B, 4.4% in Group C and 28.9 % in Group D. In the previous year, 24.6% of the pateints had at least 2 exacerbation and 8.9% of patients were hospitalized due to an exacerbation. The most common comorbidities were cardiovascular disease (47.36%) and diabetes mellitus (19.2%). The most common prescribed medications were ICS+LABA+LAMA with rates of 40% in group A, 60.1% in group B, 60% in group C and 75.8% in group D, respectively.
CONCLUSIONS: Contrary to initial recommendations, the study found that ICS in combination with LABA and LAMAs were overprescribed in groups A and B. Nearly one fourth of the patients were frequent exacerbators and nearly half of the patients had cardiovascular comorbidities. Inhaled corticosteroids in combination with LABAs and LAMAs should be used for those who are in Groups C and D. Therefore, compliance to the new GOLD framework is an important issue in the treatments of COPD patients.
CLINICAL IMPLICATIONS: There is an overuse of Inhaled corticosteroids in combination with LABAs and LAMAs in our outpatient clinics of COPD. Therefore, the clinicians should be aware of not using so much this regimen in patients who are classified as Group A and B.
DISCLOSURE: The following authors have nothing to disclose: Alev Gurgun, Pervin Korkmaz Ekren, Abdullah Sayiner
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