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| Current Status of Inhaled Treatments in Patients with Stable Chronic Obstructive Pulmonary Disease |
| WANG Shao, ZENG Yu-qin, SONG Qing, et al |
| Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Shaoyang University,Shaoyang Hunan 422000 |
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Abstract 【Objective】 To investigate the current status of initial treatments in patients with stable chronic obstructive pulmonary disease (COPD). 【Methods】Patients with COPD were enrolled to the Department of Respiratory Disease in 13 hospitals of Hunan and Guangxi from December 2016 to March 2021. Demographic data,pulmonary function,inhaled drug treatment prescriptions,and COPD assessment test (CAT),symptom score and Medical Research Council Dyspnea Scale (mMRC) score were collected. According to the 2017 COPD Global Initiative (GOLD) guidelines,patients were divided into groups A,B,C,and D. Patients' inhaled prescriptions were compared with the recommendations of the Global Initiative for COPD (GOLD,2017) guidelines. Inhaled drug prescriptions that were inconsistent with the 2017 GOLD guidelines are considered inappropriate treatment. The difference of inhalation in patients with COPD before and after January 1,2020 was compared. 【Results】A total of 5434 patients with COPD were analyzed. The most commonly used inhaled bronchodilators were long-acting Anticholinergic (LAMA),triple therapy [inhaled glucocorticoids (ICS) + long-acting β2 receptor agonists (LABA) + LAMA] and LABA/ICS,accounting for 38.7%,36.9% and 12.8%,respectively. We found that 44.4% of patients in the Group A,58.4% in Group B,26.7% in Group C,and 5.97% in Group D received inappropriate treatment,particularly the overuse of ICS. After January 1,2020,the use rate of dual bronchodilators (double bronchodilators) increased (P<0.05),while the proportion of triple drug therapy prescriptions decreased significantly (P<0.001),when compared with before January 1,2020.【Conclusion】In clinical practice,inhaled therapy in patients with stable COPD differs from the GOLD recommendations of 2017,particularly the overuse of ICS. After the launch and application of the double-bronchodilator (LABA/LAMA),the use of ICS has a certain trend of decline,but there is still unreasonable use.
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Received: 04 August 2021
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2022, Vol. 39 
