RT Journal Article
T1 Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit
A1 López Campos, José Luis
A1 Alcazar Navarrete, Bernardino
A1 Soriano, Joan B.
A1 Soler Cataluña, Juan José
A1 Rodríguez Gónzalez-Moro, José Miguel
A1 Fuentes Ferrer, Manuel E.
A1 Calle Rubio, Myrian
AB Purpose: Current COPD management recommendations indicate that pharmacological treatment can be stepped up or down, but there are no recommendations on how to make this adjustment. We aimed to describe pharmacological prescriptions during a routine clinical visit for COPD and study the determinants of changing therapy.Methods: EPOCONSUL is a Spanish nationwide observational cross-sectional clinical audit with prospective case recruitment including 4,508 COPD patients from outpatient respiratory clinics for a period of 12 months (May 2014–May 2015). Prescription patterns were examined in 4,448 cases and changes analyzed in stepwise backward, binomial, multivariate, logistic regression models.Results: Patterns of prescription of inhaled therapy groups were no treatment prescribed, 124 (2.8%) cases; one or two long-acting bronchodilators (LABDs) alone, 1,502 (34.6%) cases; LABD with inhaled corticosteroids (ICSs), 389 (8.6%) cases; and triple therapy cases, 2,428 (53.9%) cases. Incorrect prescriptions of inhaled therapies were observed in 261 (5.9%) cases. After the clinical visit was audited, 3,494 (77.5%) cases did not modify their therapeutic prescription, 307 (6.8%) cases had a step up, 238 (5.3%) cases had a change for a similar scheme, 182 (4.1%) cases had a step down, and 227 (5.1%) cases had other nonspecified change. Stepping-up strategies were associated with clinical presentation (chronic bronchitis, asthma-like symptoms, and exacerbations), a positive bronchodilator test, and specific inhaled medication groups. Stepping down was associated with lung function impairment, ICS containing regimens, and nonexacerbator phenotype.Conclusion: The EPOCONSUL study shows a comprehensive evaluation of pharmacological treatments in COPD care, highlighting strengths and weaknesses, to help us understand how physicians use available drugs.
PB Taylor and Francis Group
SN 1178-2005
YR 2018
FD 2018-07-25
LK https://hdl.handle.net/20.500.14352/94941
UL https://hdl.handle.net/20.500.14352/94941
LA eng
NO López-Campos JL, Navarrete BA, Soriano JB, Soler-Cataluña JJ, González-Moro JMR, Ferrer MEF, Calle Rubio M. Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit. Int J Chron Obstruct Pulmon Dis. 2018;13:2279-2288. 
NO Sociedad Española de Neumología y Cirugía Torácica
DS Docta Complutense
RD 7 abr 2025