The proposed study will evaluate (for newly diagnosed Chronic Obstructive Pulmonary Disease (COPD) patients)the time taken to prescription of triple therapy by aiming to answer these following research questions: 1. The percentage of patients prescribed triple therapy, and when they first started receiving triple therapy. 2. For patients prescribed triple therapy, the time taken to triple therapy from initial diagnosis of COPD. 3. The variation in treatment pathways. 4. The factors associated with time taken to triple therapy.
Triple therapy consists of long-acting beta agonist (LABA) + inhaled corticosteroids (ICS) + long-acting muscarinic antagonist (LAMA) and typically should be reserved for patients who have severe to very severe (FEV1 \<50%) COPD symptoms or for patients who have two or more exacerbations per year. However previous research from RiRL indicate that 50% of patients at GOLD stage II (moderate) receive ICS of which half were on triple therapy. To allow for multiple analysis regarding the factors that influence the likelihood of being prescribed triple therapy, a bespoke COPD dataset will be created to include: 1. Disease severity markers: 2. Confirmation of a COPD diagnosis at initial date of COPD diagnosis 3. Standard co-morbidities fields 4. Demographic fields This retrospective, observational study using data of COPD patients will assess treatment pathways (changes/step up) from initial date of COPD diagnosis with the prescription of triple therapy as the endpoint. Specific questions that will be asked are: 1. Does the percentage of COPD patients prescribed triple therapy vary dependent on time of initial date of COPD diagnosis? 2. Does the time taken to the prescription of triple therapy vary dependent on initial date of COPD diagnosis?
Study Type
OBSERVATIONAL
Enrollment
20,154
Research in Real Life Ltf
Cambridge, United Kingdom
Triple Therapy Status
The proportion of patients prescribed triple therapy and whether they were prescribed it prior to, at, or after initial date of COPD diagnosis.
Time frame: 1 year
Initial date of COPD diagnosis
The date that patients were initially diagnosed with COPD. Categorised into cohorts- 1997-2001, 2002-2006, 2007-2010.
Time frame: 1 year
Lung function grade
Patient lung function grade, calculated by GOLD I, II, III, IV criteria.
Time frame: 1 year
Asthma Diagnosis
Proportion of patients with a co-morbid asthma diagnosis
Time frame: 1 year
COPD patient group
Patients COPD patient group, calculated by GOLD A, B, C, D criteria dependent on symptoms and risk of patient.
Time frame: 1 year
COPD exacerbations (Clinical experience based)
Number of the following: (i) Asthma/copd-related\*: a. Hospital attendance / admissions OR b. A\&E attendance OR (ii) GP consultations for lower respiratory related tract infections
Time frame: 1 year
Smoking Status
Patient smoking status, taken from routine and questionnaire data
Time frame: 1 year
BMI
Patient BMI class
Time frame: 1 year
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COPD co-morbidities
COPD co-morbidities are identified via Read codes that are recorded at any time. Co-morbidities are: GERD, Rhinitis, Heart Failure, Ischaemic Heart Disease, Diabetes, Osteoporosis, Chronic Renal Failure, Chronic Kidney Disease and Anxiety-Depression
Time frame: 1 year