Comparison of Characteristics Between ICS-Treated COPD Patients and ICS-Treated COPD Patients with Concomitant Asthma: A Study in Primary Care

Abstract

Background and Objective

Inhaled corticosteroids (ICS) for COPD has been much debated. Our aim was to identify characteristics associated with prescribing ICS for patients with COPD alone compared to those with concomitant asthma in general practice.

Patients and Methods

Participating general practitioners (GPs) (n=144) recruited patients with COPD (ICPC 2nd ed. code R95) currently prescribed ICS (ACT code R03AK and R03BA). Data, if available, on demographics, smoking habits, spirometry, COPD medication, dyspnea score, and exacerbation history were retrieved from the medical records. Logistic regression analysis was used to identify possible differences in characteristics between patients with COPD alone compared to those having a concomitant diagnosis of asthma.

Results

A total of 2.289 (45% males) COPD patients on ICS were recruited. Compared to patients with COPD alone (n=1.749), those with COPD and concomitant asthma (n=540) were younger (p<0.001), had higher BMI, higher FEV ₁/FVC ratio, higher blood eosinophil count and less life-time tobacco exposure (36 and 26 pack-years, respectively). Compared to COPD alone, logistic regression analysis showed that COPD with concomitant asthma was significantly associated to age (OR 0.94; CI 0.92 to 0.97; p<0.001), pack-years of smoking (OR 0.98; CI 0.97 to 0.99; p<0.001), %pred (OR 1.02; CI 1.00 to 1.03; p=0.005), and doctor-diagnosed depression (OR 2.59; CI 1.20 to 5.58; p=0.015).

Conclusion

In COPD patients currently prescribed ICS, the presence of concomitant asthma was associated with being younger, having less tobacco exposure, more preserved lung function and a higher likelihood of doctor-diagnosed depression compared to COPD alone.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 28 April 2020

Publication date Collection: 2020

Volume: 15

Pages: 931-937

Affiliations

[1 ]Department of Respiratory Medicine, Hvidovre Hospital , Hvidovre, Denmark

[2 ]Institute of Clinical Medicine, University of Copenhagen , Copenhagen,Denmark

[3 ]Værløse Lægehus , Værløse, Denmark

[4 ]Lægehuset Remisen , Præstø, Denmark

Author notes

Correspondence: Charlotte Suppli Ulrik Respiratory Research Unit, Department of Respiratory Medicine, Hvidovre Hospital , HvidovreDK-2650, Denmark Email [e-mail]

Article

Publisher ID: 241561

DOI: 10.2147/COPD.S241561

PMC ID: 7196437

Copyright statement: © 2020 Savran et al.

License:

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Page count

Figures: 3, Tables: 4, References: 36, Pages: 7

Categories

Subject: Original Research