P185 Quantification and Treatment Patterns of Real-World Patients Classified by the GOLD 2011 Strategy

Abstract

, 75.2% [p=0.02]), diabetes (6.5, 17.8, 18.9% [p=0.20]) and obesity (0, 12.6, 16.8% [p=0.04]) increased across groups A, B and D respectively. Due to low numbers, group C was excluded from the comparison analysis. Conclusion 2.8% of patients qualified as high risk/low symptoms suggesting this patient type is rare based on a CAT evaluation, using mMRC this proportion was 19.1%. An education gap exists regarding the appropriate use of ICS given the high proportion of treated low risk patients. CV and metabolic comorbidities are more prevalent with increasing risk/symptoms so a holistic approach may be necessary, especially for group D patients. QUANTIFICATION AND TREATMENT PATTERNS OF P185[5%] were enrolled in other research, and 37 [21%] were unsuitable for other reasons). 8 appointments were pending with screening data available for 95 patients (Table 1). 40 patients (42%) did not satisfy the spirometric inclusion criteria; 27 did not show airflow obstruction, 10 had mild COPD, and 3 had asthma. Approximately 25 contact letters and up to £260 were therefore required per eligible patient identified. Conclusion A high proportion of patients on primary care databases fail to meet spirometric criteria for COPD trials and the screening failure rate via this recruitment pathway is much higher than previously reported. A large number of initial contacts are required for each patient identified. COPD patients are increasingly managed in primary care and these findings therefore have implications for planning future studies. Objectives The GOLD 2011 Strategy now recommends assessment based on exacerbation history and symptoms in addition to airflow limitation. Our goal was to better understand this classification system by analysing the distribution of patients across the 4 groups, their treatment and comorbidities in a real-world population. Methods GOLD 2011 criteria were applied to a German COPD population sampled from the Adelphi Respiratory Disease Specific Programme undertaken in 2011. Patients were recruited from consulting primary and specialist physicians. Chi-squared tests were performed. Results 507 patients had a FEV 1 value and/or exacerbation history and COPD Assessment Test (CAT) score. 10.5% of patients scored 0-9 using CAT, resulting in an uneven distribution of patients in P184Abstract P183 Table 1 on 12 May 2018 by guest. Protected by copyright.

Chronic obstructive pulmonary disease (COPD) assessment test scores corresponding to modified Medical Research Council grades among COPD patients

“…We did not identify any racial difference, although the distribution varied. Among 1,508 COPD patients from the Adelphi Respiratory Disease Specific group, the proportions of patients in subgroups A, B, C, and D when evaluated by CAT were 10%, 49%, 1%, and 40%, and when evaluated by mMRC were 39%, 20%, 13%, and 28%, respectively [ 15 ], showing an extremely small fraction for subgroup C when using the CAT criterion. Among 1,817 patients from the Health-Related Quality of Life in European COPD study, the proportions of patients in subgroups A, B, C, and D when evaluated by CAT were 8.1%, 19.2%, 9.1%, and 63.3%, and when evaluated by mMRC were 20.5%, 6.8%, 36.7%, and 35.9%, respectively [ 16 ].…”

Recent advances in COPD disease management with fixed-dose long-acting combination therapies

“…Despite the GOLD strategy recommendations, studies of prescription patterns reveal that LABA/ICS combinations are commonly prescribed to low-risk patients (groups A and B) in many countries [110][111][112]. In addition, the patient demographics from the QVA149 ILLUMINATE study also point to the overuse of ICS in the treatment of patients with COPD; around 30% of patients in the study were receiving ICS at baseline, despite being classified as GOLD group B [34].…”

Cost-effectiveness of the LABA/LAMA dual bronchodilator indacaterol/glycopyrronium in a Swedish healthcare setting

“…The objectives of this study were to compare IND/GLY with the free combination of indacaterol plus glycopyrronium (IND þ GLY) in terms of costs and to evaluate its cost-effectiveness versus the fixed-dose combination of salmeterol/fluticasone (SFC), in moderate to severe COPD population with a low-exacerbation risk from a Swedish societal perspective. Although SFC is not recommended for use in COPD patients with low exacerbation risk [1] it was included as a comparator as it is often used in such patients in clinical practice [18]. This cost-effectiveness analysis aims therefore to provide the longer-term evidence in terms of quality-adjusted life years (QALYs) and costs of using IND/GLY combination over SFC in a moderate-tosevere COPD population with low-exacerbation risk.…”