RT Journal Article
SR Electronic
T1 Medication and preventive measures for COPD in the BOLD study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p4120
VO 38
IS Suppl 55
A1 Louisa Gnatiuc
A1 Bernet Kato
A1 Sonia Coton
A1 Sonia Buist
A1 Peter Burney
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p4120.abstract
AB Background: Inhaled beclomethasone and salbutamol are three to five times as expensive in poorest settings resulting in poor access (Ait-Khaled N, Rev Mal Respir 2006, 23, 10S76-10S79). We used the BOLD data to describe differences in reported medication use for COPD.Methods: Preventive measures for COPD (flu vaccine in last year, advice or medication ever to stop smoking) and use of respiratory medications in the last year among population-based samples of adults aged 40+ with spirometrically defined COPD, were assessed across 18 BOLD sites.Results: Over 14,300 subjects had information on flu vaccine and medication use. Over 7,900 had information on smoking cessation. Prevention strategies and medication use were significantly more common in the High Income Countries (HIC) and in people with COPD than in Low and Middle Income Countries (LMIC) and those with normal spirometry (p<0.000). Differences across countries were not related to COPD prevalence.Bronchodilators and inhaled corticosteroids use increased with age, severity of COPD, BMI, any comorbidity or respiratory symptom and it was higher among the unemployed (p<0.000). After stratifying by country economic level, the use of these medicines was independent of education level and higher among the unemployed in HICs (p<0.000). The use of medication was not related to pack-years of smoking. However, after stratifying by gender the use bronchodilators and inhaled corticosteroids was significantly higher in women smoking 20+ pack-years (p=0.04).Conclusion: The use of COPD prevention and medication is significantly higher in HICs than in LMICs. Improving access to care in LMICs is important, as is understanding risk factors for low medication uptake.