MedWire News: Most patients with chronic obstructive pulmonary disease (COPD) do not use prescribed medications during their last year of life, study findings show.
“Most studies have found that patients with more severe disease tend to be more persistent or adherent with their medications,” write A Simon Pickard (University of Illinois, Chicago, USA) and fellow researchers.
“In COPD, studies of medication persistence and compliance tend to observe that early discontinuation occurs among a large number of COPD patients,” the authors observe in the journal Respiratory Medicine.
Although patterns of early medication use are well researched, it is not known whether adherence patterns change as patients approach the end of their lives.
To investigate, Pickard et al studied medical records of medication use for 11,376 individuals with COPD. The researchers studied four different categories of medications for treating COPD, namely inhaled corticosteroids, long-acting β2-agonists, methylxanthines, and anticholinergics, alone or in combination.
Surprisingly, the authors found that only around half of all patients studied had used any medication at all during their final year of life.
Patients’ use of anticholinergics and methylxanthines increased across their final year of life; however, 40% of those prescribed only one medication stopped using it within 30 days, while a further 30% discontinued within 90 days.
“This study is the first, to our knowledge, that examines patterns of medication use at the last year of life in COPD patients,” summarize the investigators, who add that quality of care is less thoroughly researched in patients with COPD than in conditions such as cancer.
The study raises a number of issues about possible suboptimal use of respiratory-related medications among COPD patients, conclude Pickard and team. They suggest that these “could be illuminated through qualitative research methods that would involve interviews with patients and clinicians.”
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