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

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Anonym412392
not rated yet Feb 12, 2018
I have had emphysema for about five years. I was on oxygen during the day but not at night. I could go about two hours without the oxygen, and then I need it. I had a converter in the house and oxygen tanks for when I go shopping, etc. I am 64 years old and in relatively good health. The doctor said it was caused by a combination of smoking, dust here in Vegas, and 30 years of smog in California. I believed I will always need the oxygen to breathe. I quit smoking 15 years ago. But the damage has been done. January 2017 my pulmonologist and I decided to go with natural treatment and was introduced to Green House Herbal Clinic natural organic Emphysema Herbal formula, i had a total decline of symptoms with this Emphysema Herbal formula treatment. Visit Green House Herbal Clinic official web-site ww w. greenhouseherbalclinic. com. The infections, shortness of breath, fatigue, dry cough and other symptoms has subsided.  I am very pleased with this treatment. I breath very well now

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