Characterising patterns of prescribing for UK COPD patients with comorbidities or history of pneumonia

Background : High doses of inhaled corticosteroids (ICS) can increase risk of type 2 diabetes, osteoporosis and pneumonia (Price, D. et al. Prim Care Respir J 2013; 22:92-100). Aim : To characterise prescribing patterns for UK COPD patients with comorbidities or history of pneumonia commencing first maintenance therapy for COPD. Methods : Retrospective observational study, using Optimum Patient Care Research Database, of patients prescribed first maintenance therapy for COPD (ICS, long-acting β agonist [LABA], long-acting muscarinic antagonist [LAMA] or combination) in 2009-2012 at or after COPD diagnosis confirmed by spirometry. Study period was 1 year before and 1-3 years after prescription for therapy. Therapy, comorbidities and history of pneumonia were recorded. Results : Of 2217 patients (55% male; 45% smokers; 47% ex-smokers; 22% aged ‹60 years; 54% 60-75 years; 24% ≥75 years) 24%, 11%, 7% and 17% had, at any time, diabetes and/or therapy, osteoporosis, history of pneumonia and asthma, respectively. Conclusion : ICSs and their combinations are prescribed frequently for COPD patients with diabetes, osteoporosis and history of pneumonia, who might be more at risk of ICS side effects, while bronchodilator monotherapy is prescribed frequently for COPD patients with asthma who might benefit from added ICS.