Muscarinic Antagonists; Adrenergic beta-2 Receptor Agonists; Adrenal Cortex Hormones; Bronchodilator Agents; Humans; Administration, Inhalation; Adrenergic beta-2 Receptor Agonists/therapeutic use; Europe; Prescriptions; Adrenal Cortex Hormones/therapeutic use; Drug Therapy, Combination; Bronchodilator Agents/therapeutic use; Pulmonary Disease, Chronic Obstructive/drug therapy; Pulmonary Disease, Chronic Obstructive; Pulmonary and Respiratory Medicine; Public Health, Environmental and Occupational Health; Family Practice
Abstract :
[en] This study aims to understand healthcare professionals' thoughts and motivations about optimal management and treatment of patients with chronic obstructive pulmonary disease (COPD). We conducted a DELPHI survey through an online questionnaire distributed to 220 panellists from six European countries and a discrete choice experiment to describe the relationship between selected clinical criteria and the initial COPD treatment of choice. One hundred twenty-seven panellists (general practitioners [GPs] and pulmonologists) completed the survey. Despite the familiarity and use (89.8%) of the GOLD classification for initial treatment selection, a frequent use of LAMA/LABA/ICS was noted. In fact, panellists agreed that inhaled corticosteroids (ICS) are over-prescribed in the primary care setting. Our study showed that GPs felt less confident than pulmonologists with ICS withdrawal. This mismatch observed between best practice and behaviour indicates the need to increase awareness and efforts to improve the adherence to guidelines in clinical practice.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Kocks, Janwillem ; General Practitioners Research Institute, Groningen, The Netherlands. janwillem@gpri.nl ; Observational and Pragmatic Research Institute, Singapore, Singapore. janwillem@gpri.nl ; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. janwillem@gpri.nl ; Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. janwillem@gpri.nl
Ferreira, António Jorge; Faculty of Medicine, University of Coimbra, Coimbra, Portugal ; Pulmonology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
Bakke, Per; Department of Clinical Science, University of Bergen, Bergen, Norway
van Schayck, Onno C P; Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
Ekroos, Heikki; Department of Pulmonary Medicine, Porvoo Hospital, Porvoo, Finland
Tzanakis, Nikolaos; Department of Thoracic Medicine, University Hospital of Heraklion, Medical School, University of Crete, Crete, Greece
Soulard, Stéphane ; Boehringer Ingelheim B.V., Amsterdam, The Netherlands
Haaksma-Herczegh, Monika; Boehringer Ingelheim B.V., Amsterdam, The Netherlands
We thank the panellists for their participation in the eDELPHI study and the Adelphi team (Maria Teresa Artés, Montse Pérez and Emma P. Córcoles) for the management of the project and medical writing contribution.
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