Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
A Cross-Sectional Study Assessing Appropriateness Of Inhaled Corticosteroid Treatment In Primary And Secondary Care Patients With COPD In Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.ORCID iD: 0000-0001-5093-6980
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.ORCID iD: 0000-0002-6857-5973
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.ORCID iD: 0000-0002-4098-7765
Show others and affiliations
2019 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 14, p. 2451-2460Article in journal (Refereed) Published
Abstract [en]

Purpose: Inhaled corticosteroids (ICS) are often more widely prescribed in the treatment of chronic obstructive pulmonary disease (COPD) than what is recommended in the guidelines. The aim of this study was to evaluate the appropriateness of ICS treatment in COPD patients using the algorithm proposed by the International Primary Care Respiratory Group (IPCRG) and to identify factors associated with ICS treatment.

Patients and methods: Appropriateness of ICS therapy was studied with respect to concomitant asthma, history of exacerbations and blood eosinophils (B-Eos) in a Swedish cohort of primary and secondary care patients with COPD. Factors associated with ICS were investigated using multivariable logistic regression.

Results: Triple treatment was found to be the most common treatment combination, used by 46% of the 561 included patients, and in total 63% were using ICS. When applying the IPCRG algorithm, there was a possible indication for discontinuation of ICS in 55% of the patients with ICS treatment. Of the patients not using ICS, 18% had an indication for starting such treatment. The strongest factors associated with ICS therapy were frequent exacerbations (aOR 8.61, 95% CI 4.06, 20.67), secondary care contacts (aOR 6.99, 95% CI 2.48, 25.28) and very severe airflow limitation (aOR 5.91, 95% CI 1.53, 26.58).

Conclusion: More than half of the COPD patients on ICS met the criteria where withdrawal of the treatment could be tried. There was, however, also a subgroup of patients not using ICS for whom there was an indication for starting ICS treatment. Patients using ICS were characterized by more frequent exacerbations and lower lung function.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD , 2019. Vol. 14, p. 2451-2460
Keywords [en]
ICS, pharmacological management, inappropriate therapy, chronic obstructive pulmonary disease, IPCRG
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-397585DOI: 10.2147/COPD.S218747ISI: 000494042200001OAI: oai:DiVA.org:uu-397585DiVA, id: diva2:1372722
Funder
Swedish Heart Lung FoundationAvailable from: 2019-11-25 Created: 2019-11-25 Last updated: 2019-11-25Bibliographically approved

Open Access in DiVA

fulltext(4395 kB)8 downloads
File information
File name FULLTEXT01.pdfFile size 4395 kBChecksum SHA-512
0b83bd2d3bce91b96cc27d5e763c10d810fe40883531a59d0f859e3f6bb6cf9d698e3e6605c02a88707b1e14f23004bdba726be9b12baeced2c8f9407c32b852
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Sulku, JohannaJansson, ChristerMelhus, HåkanMalinovschi, AndreiStällberg, BjörnBröms, KristinaHögman, MarieannLisspers, KarinHammarlund-Udenaes, MargaretaNielsen, Elisabet I.
By organisation
Department of Pharmaceutical BiosciencesCentre for Research and Development, GävleborgLung- allergy- and sleep researchClinical pharmacogenomics and osteoporosisClinical PhysiologyFamily Medicine and Preventive Medicine
In the same journal
The International Journal of Chronic Obstructive Pulmonary Disease
Respiratory Medicine and Allergy

Search outside of DiVA

GoogleGoogle Scholar
Total: 8 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 45 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf