Characterization of chronic obstructive pulmonary disease prescribing patterns in the United States

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States. Guideline recommendations for medication therapy include the use of inhaled medications for management of stable COPD. There are limited data available describing prescribing percentages of medications in patients with COPD.

Aim: To determine the prescribing percentages of medications for COPD in a national, cross-sectional study.

Methods: This was a national, cross-sectional study using data from the National Ambulatory Medical Care Survey (NAMCS) in 2013. Patients were included if they had an International Classification of Diseases (ICD) 9 code for COPD and were greater than 18 years of age. Data describing patient demographics, provider demographics and prescribed medications were collected. Data were analyzed using sample weights to account for the multi-stage sample design.

Results: On weighted analysis, 15,821,000 patient visits were included. Patients were predominantly female, greater than 40 years of age and white, non-Hispanic. The most common provider type was primary care provider. At least one COPD medication was prescribed to 64.8% of included patients. Prescription of short-acting bronchodilators was most common in this cohort and observed at a percentage of 42.5%. A long-acting bronchodilator or inhaled corticosteroid was prescribed to 32.3% of included patients. The most common long-acting bronchodilator used was long-acting beta-agonist therapy in 21.3% of patients.

Conclusion: This study describes patients with COPD from a nationally representative sample. The percentage of maintenance medication prescribing indicates further opportunity for medication optimization in the outpatient setting for patients with COPD.