Introduction
Despite standardized diagnostic and treatment approaches for COPD, there is poor adherence to treatment recommendations. The MISTRAL study evaluated therapeutic approach according to GOLD 2011 in Italian COPD patients. Here we report adherence to GOLD recommendations for COPD treatment, along with ICS use and persistence to ongoing therapy in these patients.
Methods
MISTRAL was a prospective, observational cohort study of COPD patients, grouped in 2 cohorts based on the exacerbation history (frequent exacerbators [FE], =2 exacerbations; non-frequent exacerbators [NFE], =1 exacerbation).
Results
A total of 1468 patients were evaluated (FE, 526, NFE, 942). A higher proportion of patients classified as FE at baseline, were later categorized as NFE at 12- and 24-month follow-up. Adherence to GOLD 2011 recommendations was higher in FE vs NFE at all visits (Table 1). Persistence to ongoing therapy at baseline was considerably high and only 29 patients (FE, 5; NFE, 24) discontinued the treatment despite a great degree of therapy changes. Changes in treatment were more frequent in FE vs NFE.
Conclusion
Adherence to GOLD 2011 treatment recommendations was only partially met, and was higher in FE vs NFE. The lower adherence in NFE was mostly related to ICS overuse.