Real-life use of fluticasone propionate/salmeterol in patients with chronic obstructive pulmonary disease: a French observational study

BMC Pulmonary Medicine

Isabelle Boucot⁵  Stéphane Schück³  Nathalie Texier³  Déborah Poirier³  Bruno Housset⁴  Philippe Serrier¹  Eric Van Ganse²  Céline Pribil⁶  Nicolas Roche⁷ 

[1] Private Medical Practice, Paris, France;Department of Pharmacoepidemiology, CHU-Lyon, Lyon, France;Kappa Santé, Paris, France;Department of Pulmonology, CHI Creteil Hospital, Créteil, France;Respiratory and Immuno-Inflammation Department, GlaxoSmithKline, Marly Le Roi, France;Department of Pharmacoepidemiology and Medico-Economic Modelling, GlaxoSmithKline, Marly Le Roi, France;Respiratory and Intensive Care Medicine, Cochin Hospital Group, AP-HP, University Paris Descartes, HIA du Val de Grâce 4e C, Paris, France

关键词: Pulmonologist;    Primary care;    Population-based;    Questionnaire;    Prescription;    GOLD;    France;    COPD;   

Others  :  863105
DOI  :  10.1186/1471-2466-14-56

 received in 2013-10-31, accepted in 2014-03-24,  发布年份 2014

【 摘 要 】

Background

In Europe, administration of an inhaled corticosteroid (ICS) combined with a long-acting β2 agonist is approved in chronic obstructive pulmonary disease (COPD) patients with a pre-bronchodilator FEV₁ < 60% predicted normal, a history of repeated exacerbations, and who have significant symptoms despite regular bronchodilator therapy. Minimal data are available on the use of the fluticasone propionate/salmeterol xinafoate combination (FSC) in the real-life COPD setting and prescription compliance with the licensed specifications.

Methods

A French observational study was performed to describe the COPD population prescribed with FSC, prescription modalities, and the coherence of prescription practices with the market authorized population. Data were collected for patients initiating FSC treatment (500 μg fluticasone propionate, 50 μg salmeterol, dry powder inhaler) prescribed by a general practitioner (GP) or a pulmonologist, using physician and patient questionnaires.

Results

A total of 710 patients were included, 352 by GPs and 358 by pulmonologists. Mean age was over 60 years, and 70% of patients were male. More than half were retired, and overweight or obese. Approximately half were current smokers and one-third had cardiovascular comorbidities. According to both physician evaluation and GOLD 2006 classification, the majority of patients (>75%) had moderate to very severe COPD. Strict compliance by prescribing physicians with the market-approved population for dry powder inhaler SFC in COPD was low, notably in ICS-naïve patients; all three conditions were fulfilled in less than a quarter of patients with prior ICS and less than 7% of ICS-naïve patients.

Conclusions

Prescription of dry powder inhaler SFC by GPs and pulmonologists has very low conformity with the three conditions defining the licensed COPD population. Prescription practices need to be improved and systematic FEV₁ evaluation for COPD diagnosis and treatment management should be emphasized.

【 授权许可】

   
2014 Roche et al.; licensee BioMed Central Ltd.

【 图 表 】

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