Chronic lung disease treatment in New Zealand often not consistent with international guidelines

December 19, 2017, University of Otago

University of Otago researchers have found that the treatment of chronic obstructive pulmonary disease (COPD) in New Zealand frequently does not conform to international guidelines.

The disease, often known as emphysema and usually caused by smoking, is a common cause of hospital admissions and death, and affects an estimated 100,000 people in New Zealand.

The mainstays for COPD are inhaled long-acting bronchodilators – long-acting beta-2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs).

In a nationwide study just published online in the journal Respirology, University of Otago researchers from the Pharmacoepidemiology Research Network followed New Zealanders with COPD from the time they first started a LABA and/or LAMA inhaler and examined their treatment patterns over time.

"We observed complex patterns of therapy: people switched between different combinations of LABA, LAMA, and steroid inhalers, and periods without treatment were common," says Dr. Jack Dummer, respiratory physician and study co-author.

"Use of long-term was also inconsistent with guidelines: this type of treatment was common, and people with few flare-ups of their disease were over-treated with inhaled steroids, while people with more frequent flare-ups were under-treated."

Dr. Dummer says guidelines issued by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend the initial use of a LABA or LAMA inhaler in people with COPD who have more than occasional symptoms, and the addition of a second long-acting bronchodilator in those with persistent symptoms. For people with frequent flare-ups, the addition of a long-term inhaled steroid may reduce the number of flare-ups, but inhaled steroids have no benefit in the remaining patients with COPD.

"Recent studies in several countries have found that prescribing practice does not adhere to international or national COPD treatment guidelines", says lead author, Dr. Lianne Parkin.

"However, it was not known what was happening in New Zealand."

Explore further: LAMA plus LABA tied to fewer exacerbations in stable COPD

More information: Lianne Parkin et al. Patterns of use of long-acting bronchodilators in patients with COPD: A nationwide follow-up study of new users in New Zealand, Respirology (2017). DOI: 10.1111/resp.13235

Related Stories

LAMA plus LABA tied to fewer exacerbations in stable COPD

October 4, 2017
(HealthDay)—Treatment with long-acting muscarinic antagonists (LAMA) plus long-acting β-agonists (LABA) is associated with fewer exacerbation events in patients with chronic obstructive pulmonary disease (COPD), according ...

COPD treatment with two types of bronchodilators

February 10, 2017
Dear Mayo Clinic: I was recently diagnosed with chronic obstructive pulmonary disease (COPD). Why do I have different inhalers?

Treating asthma or COPD with steroid inhaler raises the risk of hard-to-treat infections

September 20, 2017
Older people who use steroid inhalers for asthma or chronic obstructive pulmonary disease (COPD) are more likely to suffer particular bacterial infections, according to a large study published in the European Respiratory ...

Trial of new triple inhaler shows 20 percent reduction in COPD flare-ups

April 3, 2017
Flare-ups in chronic obstructive pulmonary disease, the UK's fourth leading cause of death, can be reduced by 20% by a combined triple inhaler, according to the results of a trial of more than 2,000 people conducted by The ...

Once-daily triple-Tx improves lung function, HRQoL in COPD

August 22, 2017
(HealthDay)—For patients with chronic obstructive pulmonary disease (COPD), once-daily single-inhaler triple therapy is better for lung function and health-related quality of life than inhaled corticosteroid (ICS)/long-acting ...

Long-acting inhaler may help in early stage COPD, too

September 7, 2017
(HealthDay)—The inhaler medication Spiriva (tiotropium bromide) may help slow the progression of COPD if given in the early stages of the disease, a new study suggests.

Recommended for you

Anticancer drug offers potential alternative to transplant for patients with liver failure

August 15, 2018
Patients suffering sudden liver failure could in the future benefit from a new treatment that could reduce the need for transplants, research published today shows.

Study shows how MERS coronavirus evolves to infect different species

August 14, 2018
In the past 15 years, two outbreaks of severe respiratory disease were caused by coronaviruses transmitted from animals to humans. In 2003, SARS-CoV (severe acute respiratory syndrome coronavirus) spread from civets to infect ...

Why do women get more migraines?

August 14, 2018
Research published today reveals a potential mechanism for migraine causation which could explain why women get more migraines than men. The study, in Frontiers in Molecular Biosciences, suggests that sex hormones affect ...

Inching closer to a soft spot in isoniazid-resistant tuberculosis

August 14, 2018
Antibiotic-resistant tuberculosis is a public health threat. TB and other bacteria become resistant to antibiotics by evolving genetic changes over time, which they can do quite quickly because bacterial lifecycles are short. ...

How long is an Ebola survivor contagious? One case is causing scientists to rethink the answer.

August 14, 2018
Surviving Ebola isn't like getting over the flu.

Link between common 'harmless' virus and cardiovascular damage

August 13, 2018
Researchers from Brighton and Sussex Medical School (BSMS) have found an unexpectedly close link between a herpes virus and the occurrence of immune cells damaging cardiovascular tissue.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.