@article {KaplanP809, author = {Alan Kaplan and Marie-Andree Cyr}, title = {Family physicians step therapy up in symptomatic COPD patients differently than respiratory specialists}, volume = {44}, number = {Suppl 58}, elocation-id = {P809}, year = {2014}, publisher = {European Respiratory Society}, abstract = {On December 6, 2011, Health Canada approved Indacaterol, a once a day long acting beta-antagonist (LABA) for COPD. Physicians are challenged to reassess their prescribing behaviors and usage of LABA/ICS combination.Aim: To compare physician current and anticipated usage of Indacaterol, its place in therapy, and level of comfort toward this non ICS therapy.Methods: 45 minutes online survey of family physicians (n= 75) and respirologists (n=40) across Canada.Results: 92\% of family physicians were aware of Indacaterol, 2 years after approval. This correlated with an estimated current 4\% share of treatment and an anticipated 8\% within 6 months, as per intention to prescribe. Respirologists awareness was slightly higher 97\%, with current estimated share of treatment 6\% and an anticipated 9\% within the next 6 months. Both groups position Indacaterol as a COPD add-on therapy to a LAMA. Attitude towards LABA/ICS FDC is the main difference amongst the 2 groups. Study found that 13 \% of FP estimated that LABA/ICS should be the 1st step up therapy compared to 5\% for respirologists. Another 35 \% of FPs legitimized ICS use as a means to proactively manage inflammation in COPD compared to only 5\% of respirologists.Conclusion: Clearly, education on inflammation in the pathogenesis of COPD is necessary to differentiate the condition vs. asthma. This will be crucial to ensure the proper use of ICS in COPD, ie., in frequent exacerbators. It will also establish, as per our Canadian Thoracic Society guidelines, that an ICS-sparing treatment, such as Indacaterol, would be a superior and safer step up after LAMA therapy for persistent COPD symptoms in non-exacerbating patients than ICS/LABA FDC.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/44/Suppl_58/P809}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }