Source: Annual Congress 2001 - Long-acting β2-agonists: clinical effects
Disease area: Airway diseases

Abstract

Inhaled long acting B₂ agonists (LA-B2 ) are widely used to treat obstructive airway disease. The British Thoracic Society has published COPD guidelines restricting their use to regularly reviewed patients with proven reversibility. The Cochrane Group recommends continuing LA-B2 in patients with limited reversibility only if there is spirometric or symptomatic benefit. To assess appropriate use of these drugs, we reviewed LA-B2 agonists in all COPD patients seen during 1 calendar month at 2 geographically distinct general hospitals in NW England (105 and 112 patients respectively). The 2 groups were similar (mean age 68.5 and 67.2 years, mean FEV1% predicted 42 and 38, males 46 and 60). Inhaled LA-B2 were used by 35% and 43%, of which 35% and 31% had moderate COPD and 49% and 54% severe COPD. 46% and 44% had reversibility testing to B2 agonists (mean % reversibility 5.7 and 4.4). LA-B2 were prescribed by the patient's general practitioner in 86% and 69% with only 14% and 31% prescribed by hospital. However, only 49% and 45% had their use of LA-B2 reviewed, 78% and 81% by hospital.When questioned, 5% and 2% reported the inhaler to be very helpful, 30% and 29% quite helpful and 65% and 69% not helpful. There was no correlation between patient's perception and the severity of COPD or B2 reversibility.
In conclusion, the use of LA-B2 was similar in both hospitals with most LA-B2 prescribed by general practitioners, with most patients not having appropriate therapy review. Adherence to the current guidelines appears to be poor.

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Citations should be made in the following way:
M. Al-Aloul, M. J. Walshaw, M. J. Ledson (Liverpool, United Kingdom). Appropriateness of prescribing practices of long- acting B₂ agonists in COPD in two large district general hospitals. Eur Respir J 2001; 16: Suppl. 31, 3477

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