TY - JOUR T1 - GP survey on how to incorporate LABA/LAMA fixed dose combinations (FDC) in their COPD patients JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P810 AU - Alan Kaplan AU - David Hill AU - Marie-Andree Cyr Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P810.abstract N2 - Aim: To determine Canadian GPs view on which COPD patients:a) are not optimally treatedb) should be treated with LABA/LAMA FDC.Methods: 45 1-hour, 1-on-1 interviews were conducted in Montreal, Toronto and Vancouver. GPs discussed their treatment algorithm for COPD, reviewed how they perceived the importance of ICS in COPD, and which patients would benefit from a LABA/LAMA FDC.Results: GPs suspect COPD in smokers and ex-smokers and classify based on patient symptoms and progression over ensuing visits. They ideally confirm with a spirometer test, especially to differentiate from asthma. This is often omitted by Toronto MDs, citing recent removal of government remuneration cf. Vancouver MDs. Overall a very symptomatic patient or one with frequent exacerbations is considered severe and a patient with no symptoms is mild. Mild patients are often not treated. The most common first line maintenance therapy prescribed is a LAMA. Patients with persistent complaints will receive a LABA/ICS FDC, even if they do not exacerbate. GPs consider the ideal candidate for a LABA/LAMA FDC to be a symptomatic COPD patient despite maintenance therapies, either LAMA or LABA ICS FDC. They expect that this treatment will reduce exacerbations. This could be an opportune time to reconsider the patients on a LABA/ICS FDC, recognizing that many patients may not actually need an ICS. They estimate ∼65%-70% of their patients are on triple therapy (LAMA+LABA/ICS) regardless of exacerbation status. ∼50% of the physicians mention risk of pneumonia with ICS. Mention was also made that a patient with osteoporosis, glaucoma and diabetes could benefit from an ICS-free treatment such as LAMA/LABA FDC. ER -