Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/20243
Title
Factors associated with inhaled corticosteroids prescription in primary care patients with COPD: A cross-sectional study in the Balearic Islands (Spain)
Author(s)
Date issued
2016
Citation
Román-Rodríguez M, Van Boven JFM, Vargas F, Contreras CC, Lamelas G, Gestoso S, et al. Factors associated with inhaled corticosteroids prescription in primary care patients with COPD: A cross-sectional study in the Balearic Islands (Spain). Eur J Gen Pract. 2016;22(4):232-9. Epub 2016 Sep 6.
Language
Inglés
Document type
research article
Abstract
Background: There is a worldwide over-prescription of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD), off-label prescribing, and unnecessary prescription of high doses. Objectives: Our aim was to assess the prescription rate of ICS and to identify sociodemographic and clinical factors associated with ICS prescription among patients with COPD, treated in Balearic primary healthcare. Methods: This cross-sectional study included all patients with a clinical COPD diagnosis, who attended a primary care centre of the Balearic Islands (Spain) during 2012. Also, a sub-population with spirometry-confirmed COPD was defined. Data were obtained on patient demographics, smoking status, spirometry, ICS prescriptions, other respiratory medication, exacerbations and comorbidities. Associations with ICS and high-dose ICS prescription were assessed using multivariate regression analyses. Results: In total, 15,440 patients were included (70% men, mean age 68.6 years), and 44.6% were prescribed ICS. The largest association with ICS prescription was asthma comorbidity (OR: 3.50; 95%CI: 3.12-3.92), followed by exacerbation history (OR: 2.23; 95%CI: 2.07-2.47). In addition, smoking status, spirometry, atopic dermatitis, allergic rhinitis and mean age were significantly (P<0.001) associated with ICS treatment. In the spirometry-confirmed population, asthma (OR: 2.89; 95%CI: 2.29-3.64) and exacerbations were also the major factors (OR: 2.85; 95%CI: 2.45-3.32) followed by severe bronchial-obstruction (OR: 2.63; 95%CI: 2.24-3.08). High-dose ICS prescription was mainly associated with severe obstruction (OR: 2.27; 95%CI: 1.93-2.68). Conclusion: The percentage of COPD patients prescribed ICS in Balearic primary care is relatively low. Asthma comorbidity, exacerbation history, severe bronchial-obstruction, smoking status and a spirometry-confirmed COPD diagnosis were significantly associated with ICS prescription.
Subject
Chronic obstructive pulmonary disease | Treatment | Inhaled corticosteroids | Primary care | Quality of healthcare
MESH
Aged, 80 and over | Asthma | Aged | Dose-Response Relationship, Drug | Spain | Adrenal Cortex Hormones | Pulmonary Disease, Chronic Obstructive | Humans | Smoking | Middle Aged | Cross-Sectional Studies | Male | Multivariate Analysis | Administration, Inhalation | Female | Regression Analysis | Primary Health Care | Spirometry
DECS
Espirometría | Femenino | Análisis Multivariante | Administración por Inhalación | Masculino | Fumar | Estudios Transversales | Enfermedad Pulmonar Obstructiva Crónica | Relación Dosis-Respuesta a Droga | Humanos | Persona de Mediana Edad | Anciano | Asma | Anciano de 80 o más Años | Corticoesteroides | Atención Primaria de Salud | Análisis de Regresión | España
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