| DOI: 10.29090/psa.2019.03.018.0006 | Pharm Sci Asia 2019; 46(3), 175-183 |
Treatment of COPD in one university hospital
setting in Thailand:the real-life prescribing
patterns and treatment expenditures Thidarat Samarnkongsak1,2,
Montarat
Thavorncharoensap1,
Theerasuk Kawamatawong3*
,
Oraluck Pattanaprateep4,
Farsai Chanjaruporn1,
Montaya Sunantiwat1
1 Division of Social and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University,Bangkok 10400, Thailand
2 Department of Pharmacy, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
3 Division of Pulmonary and Critical Care Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
4 Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
This study aims to examine prescribing patterns of COPD medications, adherence to The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 guideline, and impact of the adherence on clinical and economic outcomes. A retrospective study was conducted at Ramathibodi hospital. All COPD patients receiving treatment during July 1- December 31, 2012 were identified from electronic database. Index date was determined as the first date with FEV1 during the recruitment period. Data on treatment, cost, and clinical outcomes were reviewed for 1 year after index date. The results were included 109 patients. 84 patients (77.06%) and 25 patients (22.94%) were classified into group 1 (FEV1 ≥ 50%) and group 2 (FEV1 < 50%), respectively. It was found that group 1 reported significantly lower exacerbation rate (26.19% vs 80.00%) than group 2. SABA/SAMA was the most prescribed drugs (97.61% in group 1 and 100% in group 2). Overtreated with ICS was common (63.09%) with FEV1 ≥ 50%. Average annual treatment expenditure per capita was US$ 411 for group 1 and US$ 703 for group 2. No association between adherence to GOLD 2013 guidelines and clinical or economic outcomes was identified, possibly due to short duration of study. Adherence to GOLD 2013 guideline was sub-optimal. To promote the adherence to GOLD 2013 guideline, further long-term and well developed studies are clearly needed.
Keyword:
COPD; Adherence; Guideline;
Prescribing patterns; Thailand
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