Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal?
Timothy H Harries,1 Gill Gilworth,1 Christopher J Corrigan,2 Patrick B Murphy,3 Nicholas Hart,3 Mike Thomas,4 Patrick T White1 1Department of Public Health and Primary Care, School of Population Health and Environmental Sciences, King’s College London, London, UK; 2Department of Asthma All...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-01-01
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| Series: | International Journal of COPD |
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| Online Access: | https://www.dovepress.com/inhaled-corticosteroids-prescribed-for-copd-patients-with-mild-or-mode-peer-reviewed-article-COPD |
| _version_ | 1818254079720161280 |
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| author | Harries TH Gilworth G Corrigan CJ Murphy PB Hart N Thomas M White PT |
| author_facet | Harries TH Gilworth G Corrigan CJ Murphy PB Hart N Thomas M White PT |
| author_sort | Harries TH |
| collection | DOAJ |
| description | Timothy H Harries,1 Gill Gilworth,1 Christopher J Corrigan,2 Patrick B Murphy,3 Nicholas Hart,3 Mike Thomas,4 Patrick T White1 1Department of Public Health and Primary Care, School of Population Health and Environmental Sciences, King’s College London, London, UK; 2Department of Asthma Allergy and Respiratory Science, King’s College London, London, UK; 3Lane Fox Respiratory Unit, Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London, London, UK; 4Primary Care and Population Medicine, University of Southampton, Southampton, UKCorrespondence: Timothy H HarriesDepartment of Public Health and Primary Care, School of Population Health and Environmental Sciences, King’s College London 3rd Floor Addison House, Guys Campus, London SE1 1UL, UKTel +44 20 7836 5454Email timothy.harries@kcl.ac.ukAbstract: COPD patients prescribed inhaled corticosteroids (ICS) outside guidelines should be targeted for ICS withdrawal. Within a primary care population of 209,618 we used a combination of digital search algorithm, individual record review, and clinical review to identify COPD patients suitable for a trial of ICS withdrawal. At most, 39% of COPD patients with mild or moderate airflow limitation prescribed ICS were suitable for withdrawal according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Recurrent exacerbations and reversible airway obstruction were the main reasons for patients’ unsuitability for withdrawal. Identifying COPD patients in whom ICS withdrawal should be considered presents a challenge to primary care clinicians.Keywords: pulmonary disease, chronic obstructive, inhaled corticosteroids, drug withdrawal, mild airflow limitation, moderate airflow limitation |
| first_indexed | 2024-12-12T16:50:16Z |
| format | Article |
| id | doaj.art-6940c306755746f987ecd550cbcd5def |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-12T16:50:16Z |
| publishDate | 2020-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-6940c306755746f987ecd550cbcd5def2022-12-22T00:18:23ZengDove Medical PressInternational Journal of COPD1178-20052020-01-01Volume 143063306650854Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal?Harries THGilworth GCorrigan CJMurphy PBHart NThomas MWhite PTTimothy H Harries,1 Gill Gilworth,1 Christopher J Corrigan,2 Patrick B Murphy,3 Nicholas Hart,3 Mike Thomas,4 Patrick T White1 1Department of Public Health and Primary Care, School of Population Health and Environmental Sciences, King’s College London, London, UK; 2Department of Asthma Allergy and Respiratory Science, King’s College London, London, UK; 3Lane Fox Respiratory Unit, Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London, London, UK; 4Primary Care and Population Medicine, University of Southampton, Southampton, UKCorrespondence: Timothy H HarriesDepartment of Public Health and Primary Care, School of Population Health and Environmental Sciences, King’s College London 3rd Floor Addison House, Guys Campus, London SE1 1UL, UKTel +44 20 7836 5454Email timothy.harries@kcl.ac.ukAbstract: COPD patients prescribed inhaled corticosteroids (ICS) outside guidelines should be targeted for ICS withdrawal. Within a primary care population of 209,618 we used a combination of digital search algorithm, individual record review, and clinical review to identify COPD patients suitable for a trial of ICS withdrawal. At most, 39% of COPD patients with mild or moderate airflow limitation prescribed ICS were suitable for withdrawal according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Recurrent exacerbations and reversible airway obstruction were the main reasons for patients’ unsuitability for withdrawal. Identifying COPD patients in whom ICS withdrawal should be considered presents a challenge to primary care clinicians.Keywords: pulmonary disease, chronic obstructive, inhaled corticosteroids, drug withdrawal, mild airflow limitation, moderate airflow limitationhttps://www.dovepress.com/inhaled-corticosteroids-prescribed-for-copd-patients-with-mild-or-mode-peer-reviewed-article-COPDpulmonary diseasechronic obstructiveinhaled corticosteroidsdrug withdrawalmild airflow limitationmoderate airflow limitation |
| spellingShingle | Harries TH Gilworth G Corrigan CJ Murphy PB Hart N Thomas M White PT Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal? International Journal of COPD pulmonary disease chronic obstructive inhaled corticosteroids drug withdrawal mild airflow limitation moderate airflow limitation |
| title | Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal? |
| title_full | Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal? |
| title_fullStr | Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal? |
| title_full_unstemmed | Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal? |
| title_short | Inhaled Corticosteroids Prescribed for COPD Patients with Mild or Moderate Airflow Limitation: Who Warrants a Trial of Withdrawal? |
| title_sort | inhaled corticosteroids prescribed for copd patients with mild or moderate airflow limitation who warrants a trial of withdrawal |
| topic | pulmonary disease chronic obstructive inhaled corticosteroids drug withdrawal mild airflow limitation moderate airflow limitation |
| url | https://www.dovepress.com/inhaled-corticosteroids-prescribed-for-copd-patients-with-mild-or-mode-peer-reviewed-article-COPD |
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