Patterns of use of long‐acting bronchodilators in patients with COPD: A nationwide follow‐up study of new users in New Zealand

Parkin, Lianne; Barson, David; Zeng, Jiaxu; Horsburgh, Simon; Sharples, Katrina; Dummer, Jack

doi:10.1111/resp.13235

Cited by 16 publications

(21 citation statements)

References 23 publications

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“…To characterize the typology of CTs (homogeneous groups of CTs), we used a state sequence analysis (SSA) [39]. This method was specifically developed to analyse sequential data [24][25][26]. Because of the multidimensional nature of CTs (the where, why, and which dimensions), we used a modified version of SSA (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…A powerful method for the analysis of longitudinal sequential data has recently risen in healthcare research, although to our knowledge only a few studies have used this approach to describe CTs [23][24][25][26]. The State Sequence Analysis (SSA) is largely used in social sciences to describe and visualize longitudinal patterns such as life course or employment status trajectories, where each individual's trajectory consists of a succession of states and transitions [14,24,25,[27][28][29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

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Healthcare utilization after a first hospitalization for COPD: a new approach of State Sequence Analysis based on the '6W' multidimensional model of care trajectories

Vanasse

Courteau

et al. 2020

BMC Health Serv Res

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Background: Published methods to describe and visualize Care Trajectories (CTs) as patterns of healthcare use are very sparse, often incomplete, and not intuitive for non-experts. Our objectives are to propose a typology of CTs one year after a first hospitalization for Chronic Obstructive Pulmonary Disease (COPD), and describe CT types and compare patients' characteristics for each CT type. Methods: This is an observational cohort study extracted from Quebec's medico-administrative data of patients aged 40 to 84 years hospitalized for COPD in 2013 (index date). The cohort included patients hospitalized for the first time over a 3-year period before the index date and who survived over the follow-up period. The CTs consisted of sequences of healthcare use (e.g. ED-hospital-home-GP-respiratory therapists, etc.) over a one-year period. The main variable was a CT typology, which was generated by a 'tailored' multidimensional State Sequence Analysis, based on the "6W" model of Care Trajectories. Three dimensions were considered: the care setting ("where"), the reason for consultation ("why"), and the speciality of care providers ("which"). Patients were grouped into specific CT types, which were compared in terms of care use attributes and patients' characteristics using the usual descriptive statistics.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Healthcare utilization after a first hospitalization for COPD: a new approach of State Sequence Analysis based on the '6W' multidimensional model of care trajectories

Vanasse

Courteau

et al. 2020

BMC Health Serv Res

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“…The data sources and methods used to derive, and describe, the study cohort have been described previously . In brief, we obtained linked data from the New Zealand Ministry of Health's National Collections, including details of all government‐funded dispensings of prescription medicines from community pharmacies between 1 January 2005 and 31 December 2013 (from the Pharmaceutical Collection, PHARMS), publicly‐funded hospital discharges between 1988 and 31 December 2013 (from the National Minimum Dataset, NMDS), inpatient and community‐based deaths (from the Mortality Collection) and demographic information (from the National Health Index, NHI, Collection) .…”

Section: Methodsmentioning

confidence: 99%

“…COPD severity was classified according to the numbers of COPD exacerbations and hospital admissions in the 2 years preceding cohort entry (Table S2 in Supplementary Information). Concomitant dispensings of long‐acting bronchodilator and ICS products on the cohort entry date were summarized as therapeutic regimens …”

Section: Methodsmentioning

confidence: 99%

Underuse of beta‐blockers by patients with COPD and co‐morbid acute coronary syndrome: A nationwide follow‐up study in New Zealand

et al. 2019

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Background and objective Clinical guidelines recommend the use of beta‐blockers and other cardiovascular prevention drugs in patients with acute coronary syndrome (ACS). Studies in several countries have found that beta‐blockers are underused in patients with chronic obstructive pulmonary disease (COPD) and co‐morbid heart disease, although most have only examined use in subgroups of patients. We undertook a nationwide follow‐up study in New Zealand to describe the use of beta‐blockers and other cardiovascular prevention drugs in patients with COPD and ACS. Methods National health and pharmaceutical dispensing data were used to derive the study cohort, identify patients who were admitted to hospital with ACS and/or heart failure before cohort entry and during follow‐up, and ascertain drug use. Results The study cohort included 83 435 patients aged ≥45 years, with 290 400 person‐years of follow‐up. Among 2637 patients with ≥1 ACS admission during follow‐up, only 56.6% received a beta‐blocker in the 6 months following the first admission, while 87.7% and 81%, respectively, received aspirin and a statin. Patients with higher COPD severity were less likely to receive a beta‐blocker than those with lower severity, as were those with no history of previous ACS and/or heart failure. Conclusion Use of beta‐blockers following an ACS admission was much lower than expected based on the findings of general audits of ACS management in New Zealand. Along with the higher proportions using aspirin and statins, and the differences in beta‐blocker dispensing by COPD severity, this suggests a particular reluctance to prescribe beta‐blockers to patients with COPD.

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“…Parkin et al . used large national health and pharmaceutical dispensing data sets to describe prescribing patterns in New Zealand . Prescribing long‐acting bronchodilators and ICS often did not align with international guidelines; 70% of patients with mild‐to‐moderate disease were commenced on an ICS‐containing regimen, while a significant minority of those with frequent exacerbations were not prescribed an ICS.…”

Section: Copdmentioning

confidence: 99%

Contemporary Concise Review 2018: Asthma and chronic obstructive pulmonary disease

Upham

2019

Respirology

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Patterns of use of long‐acting bronchodilators in patients with COPD: A nationwide follow‐up study of new users in New Zealand

Abstract: In this nationwide study, patterns of use of LABAs, LAMAs and ICSs were complex and often did not comply with treatment guidelines. Further work is required to address the discrepancy between guidelines and prescribing practices.

Cited by 16 publications

References 23 publications

Healthcare utilization after a first hospitalization for COPD: a new approach of State Sequence Analysis based on the '6W' multidimensional model of care trajectories

Healthcare utilization after a first hospitalization for COPD: a new approach of State Sequence Analysis based on the '6W' multidimensional model of care trajectories

Underuse of beta‐blockers by patients with COPD and co‐morbid acute coronary syndrome: A nationwide follow‐up study in New Zealand

Contemporary Concise Review 2018: Asthma and chronic obstructive pulmonary disease

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