Inappropriate inhaled corticosteroid prescribing in chronic obstructive pulmonary disease patients

Amelia Harrison; Brigitte Borg; Bruce Thompson; Mark Hew; Eli Dabscheck

doi:10.1111/imj.13611

Inappropriate inhaled corticosteroid prescribing in chronic obstructive pulmonary disease patients

Intern Med J. 2017 Nov;47(11):1310-1313. doi: 10.1111/imj.13611.

Authors

Amelia Harrison¹, Brigitte Borg¹, Bruce Thompson^{1

2}, Mark Hew^{1

3}, Eli Dabscheck^{1

2}

Affiliations

¹ Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
² Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia.
³ School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

PMID: 29105270
DOI: 10.1111/imj.13611

Abstract

The Australian National Chronic Obstructive Pulmonary Disease (COPD) guidelines recommend that inhaled corticosteroids (ICS) be reserved for patients with a post-bronchodilator forced expiratory volume in 1 s (FEV₁ ) less than 50% predicted and those who experience ≥2 exacerbations in 12 months. In total, 707 COPD patients were identified from the lung function test database at our tertiary hospital; 52.4% of patients with a post-bronchodilator FEV₁ ≥50% were prescribed an ICS. Significant discordance exists between guideline recommendations and inhaler prescription.

Keywords: COPD; guidelines; inhaled corticosteroids; over prescription.

MeSH terms

Administration, Inhalation
Adrenal Cortex Hormones / administration & dosage
Adrenal Cortex Hormones / adverse effects*
Aged
Bronchodilator Agents / administration & dosage
Bronchodilator Agents / adverse effects*
Cohort Studies
Female
Humans
Inappropriate Prescribing / prevention & control
Inappropriate Prescribing / trends*
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / diagnosis
Pulmonary Disease, Chronic Obstructive / drug therapy*

Substances

Adrenal Cortex Hormones
Bronchodilator Agents