Factors Affecting Drug Prescription in Patients With Stable COPD: Results From a Multicenter Spanish Study

de Miguel Díez, J.; Izquierdo Alonso, J.L.; Molina París, J.; Bellón Cano, J.M.; Rodríguez González-Moro, J.M.; de Lucas Ramos, P.

doi:10.1016/S1579-2129(06)60399-6

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 41. Issue 2.

Pages 63-70 (February 2005)

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Pages 63-70 (February 2005)

Original Articles

DOI: 10.1016/S1579-2129(06)60399-6

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Factors Affecting Drug Prescription in Patients With Stable COPD: Results From a Multicenter Spanish Study

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J. de Miguel Díeza, J.L. Izquierdo Alonsob,

Corresponding author

jlizquierdo@sescam.org

Correspondence: Dr. J.L. Izquierdo Alonso. Sección de Neumología. Hospital General Universitario de Guadalajara. Donantes de Sangre, s/n. 19002 Guadalajara. España

, J. Molina Parísc, J.M. Bellón Canod, J.M. Rodríguez González-Moroa, P. de Lucas Ramosa

a Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain

b Servicio de Neumología, Hospital General Universitario de Guadalajara, Guadalajara, Spain

c Centro de Salud Francia, Fuenlabrada, Madrid, Spain

d Unidad de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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Abstract

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Objective

TO determine what factors are associated with prescription of drugs to patients with stable chronic obstructive pulmonary disease (COPD).

Material and Methods

We studied 568 patients with stable COPD. Assessments included determination of the severity of dyspnea, body mass index, health-related quality of life, and spirometry testing.

Results

The forced expiratory volume in 1 second was significantly associated with prescription of long-acting β2-adrenergic agonists (odds ratio [OR]=0.98; 95% confidence interval [CI], 0.96-1) and inhaled corticosteroids (OR=0.98; 95% CI, 0.96-1). Quality of life was related to administration of short-acting β2-adrenergic agonists (OR=1.02; 95% CI, 1-1.03), long-acting β2-adrenergic agonists (OR=1.02; 95% CI, 1-1.03), ipratropium bromide (OR=1.03; 95% CI, 1-1.04), theophylline drugs (OR=1.02; 95% CI, 1-1.03), and inhaled corticosteroids (OR=1.02; 95% CI, 1-1.03). The severity of dyspnea was significantly associated with prescription of oral corticosteroids (for grade IV dyspnea, OR=15.25; 95% CI, 2.40-97.02). Body mass index was not related to drug administration.

Conclusions

Drug prescription in patients with stable COPD correlates not only with forced expiratory volume in 1 second but also with other parameters such as health-related quality of life and dyspnea.

Factores determinantes de la prescripción farmacológica en los pacientes con EPOC estable. Resultados de un estudio multicéntrico español (IDENTEPOC)

Key Words:

COPD

FEV1

Health-related quality of life

Dyspnea

Treatment

Objetivo

Determinar qué factores se relacionan con la prescripción de fármacos en los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) estable.

Material Y Métodos

Se estudió a 568 pacientes con EPOC estable. La evaluación realizada incluyó la medición del grado de disnea, la determinación del índice de masa corporal, el estudio de la calidad de vida relacionada con la salud y la realización de una espirometría.

Resultados

El volumen espiratorio forzado en el primer segundo se asoció significativamente con la prescripción de β2-adrenérgicos de acción larga (odds ratio [OR] = 0,98; in-tervalo de confianza [IC] del 95%, 0,96-1) y corticoides in-halados (OR = 0,98; IC del 95%, 0,96-1). La calidad de vida se relacionó con la administración de β2-adrenérgicos de acción corta (OR = 1,02; IC del 95%, 1-1,03), β2-adrenérgicos de acción larga (OR = 1,02; IC del 95%, 1-1,03), bromuro de ipratropio (OR = 1,03; IC del 95%, 1-1,04), teofilinas (OR = 1,02; IC del 95%, 1-1,03) y corticoides inhalados (OR = 1,02; IC del 95%, 1-1,03). El grado de disnea mostró una asociación significativa con la prescripción de corticoides orales (para disnea grado IV, OR = 15,25; IC del 95%, 2,40-97,02). No se encontró ninguna relación entre la administración de fármacos y el índice de masa corporal.

Conclusiones

La prescripción farmacológica de los pacientes con EPOC estable viene determinada no sólo por el volumen espiratorio forzado en el primer segundo, sino tam-bién por otros parámetros, entre los que se incluyen la calidad de vida relacionada con la salud y la disnea.

Palabras clave:

EPOC

FEV1

Calidad de vida relacionada con la salud

Disnea

Tratamiento

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REFERENCES

[1]

JA Barberà, G Peces-Barba, AGN Agustí, JL Izquierdo, E Monsó, T Montemayor, et al.

Guía clínica para el diagnóstico y el tratamiento de la enfermedad pulmonar obstructiva crónica.

Arch Bronconeumol., 37 (2001), pp. 297-316

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