Patterns of respiratory medication us in a VA COPD cohort, 1999-2002

Lee TA, Bartle B, Weiss KB. Patterns of respiratory medication us in a VA COPD cohort, 1999-2002. Poster session presented at: American Thoracic Society Annual International Conference; 2005 May 1; San Diego, CA.

RATIONALE: Medication management is an important facet COPD treatment. Several classes of medications are used in treating COPD. Treatment guidelines propose a stepped approach to treatment, however it is not clear whether medications are used in combination or one class is substituted for another in actual practice. Our objective was to examine medication use patterns over a four-year period in a cohort of Veterans Affairs (VA) patients with COPD. METHODS: Using VA administrative data, we identified patients that were in the VA healthcare system in 1998, received their first diagnosis of COPD in 1999 and received at least 2 dispensings for respiratory medications in 1999. Only patients alive at the end of 2002 were included. We examined prescription dispensings for anticholinergics (AC), inhaled corticosteroids (ICS), long-acting beta-agonists (LABA), short-acting beta-agonists (SABA) and theophylline (THEO) over the four-year follow-up period. RESULTS: There were 144,485 patients that met our inclusion criteria. Across the years, the plurality of patients were treated with 2 drug classes except for 2002 (Figure). The proportion stopping medication treatment increased each year (Figure). In 1999, 75% of the patients were on one of five combinations: AC+SABA (24.1%), AC+ICS+SABA (20.4%), SABA (16.4%), ICS+SABA (7.6%) and AC (7.0%). The top five combinations were similar for subsequent years. CONCLUSION: A large proporation of COPD patients stopped filling their respiratory medications over a four-year period.