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- W2110277941 startingPage "181" @default.
- W2110277941 abstract "Introduction: GOLD guidelines recommend inhaled medications for COPD based on disease severity. Undertreatment denies patients the benefits of effective therapy. Overtreatment with inhaled corticosteroids (ICS) risks side-effects including both local and increased risk of pneumonia; in combination with long-acting beta-agonists they also incur considerable financial waste. This study assessed adherence to GOLD guidelines in primary care prescribing of inhaled COPD medication in South-East London. Methods: Data on management of COPD patients were extracted in 65 general practices in Lambeth and Southwark including spirometry, inhaled medications and recent COPD exacerbations. Patient severity was classed by GOLD stage and appropriateness of prescribing was assessed. Results: 4804 COPD patients were identified. Spirometry was recorded for 2941 (61%), of whom 778 did not meet GOLD diagnostic criteria. 2163 (45%) were included in the analysis. 62% were inappropriately treated according to GOLD. The most common deviation was over-prescription of ICS in GOLD I/II (55%), or III/IV with no history of severe exacerbations (56%). 793 (64%) cases of over-treatment involved LABA+ICS with a mean cost of €46.52/item. Conclusion: Diagnosis of COPD was made without spirometry in the majority of COPD patients in primary care. Deviation from GOLD in prescribing was substantial. The potential for harm due to ICS over-prescription in over half of patients with a confirmed diagnosis of COPD must give considerable cause for concern, besides the unjustified costs." @default.
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- W2110277941 date "2011-09-01" @default.
- W2110277941 modified "2023-09-22" @default.
- W2110277941 title "High rates of over-treatment of COPD in primary care: What risks to patients and costs to health services?" @default.
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