Real-world prescribing patterns among newly diagnosed COPD patients receiving ICS: An analysis of UK patient dataset
Introduction 

Real-life prescribing patterns for COPD patients may differ from GOLD strategy recommendations. This study examined prescribing patterns during one year prior to and including initial date of COPD diagnosis during study interval from 1997 to 2010, without asthma as comorbidity in different GOLD 2013 categories (GOLD A=low risk, less symptoms; GOLD B=low risk, more symptoms; GOLD C=high risk, less symptoms; GOLD D=high risk, more symptoms).

Methods 

This retrospective observational cohort study used data from a large UK patient dataset Optimum Patient Care Research that included 387 primary care practices across UK. Patients (n=16,185) were included in the analysis who were ≥40 years of age and diagnosed since 1997 with 1 year of pre- and 2 years of post-diagnosis data and spirometry supportive of COPD (FEV1/FVC<0.7).

Results 

Of the patients with known GOLD group, 79.9% did not have asthma. At the time of diagnosis, an ICS containing regimen was prescribed to 37.2% of these patients, while 32% did not receive any treatment for COPD. Prescribing patterns of COPD (non-asthma) patients with ICS containing regimens using GOLD classification was 32.8%, 36%, 42.9% and 45.8% in GOLD A, B, C, and D patients respectively.

Conclusion 

Contrary to GOLD strategy, many patients in GOLD categories A and B without asthma comorbidity are prescribed and remained on ICS containing regimen regardless of risk of exacerbations, symptoms and lung function. Many patients with COPD also remained untreated after initial diagnosis.