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Observational Study
. 2018 May 11:13:1545-1556.
doi: 10.2147/COPD.S154097. eCollection 2018.

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

Alejandro Casas  1 , Maria Montes de Oca  2 , Ana Mb Menezes  3 , Fernando C Wehrmeister  3 , Maria Victorina Lopez Varela  4 , Laura Mendoza  5 , Larissa Ramírez  6 , Marc Miravitlles  7
Affiliations
Observational Study

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

Alejandro Casas et al. Int J Chron Obstruct Pulmon Dis. .

Erratum in

Abstract

Background: Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region.

Methods: This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other.

Results: In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire.

Conclusion: COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence.

Keywords: COPD; Latin America; adherence; inhaled therapy.

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Conflict of interest statement

Disclosure AM has been paid for her work as a statistician for the LASSYC study. LR is an employee of AstraZeneca. The other authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Type and frequency of medication used, overall and by country. Note: LABA, LAMA, LABA/LAMA, ICS, ICS/LABA, ICS/LAMA/LABA, and ICS/LAMA could be used alone or in combination with SABA or SAMA. Abbreviations: LABA, long-acting β-agonist; LAMA, long-acting muscarinic antagonist; ICS, inhaled corticosteroid; SABA, short-acting β-agonist; SAMA, short-acting muscarinic antagonist.
Figure 2
Figure 2
Type of medication used according to the GOLD 2013 stage classification in the overall population. Note: LABA, LAMA, LABA/LAMA, ICS, ICS/LABA, ICS/LAMA/LABA, and ICS/LAMA could be used alone or in combination with SABA or SAMA. Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; LABA, long-acting β-agonist; LAMA, long-acting muscarinic antagonist; ICS, inhaled corticosteroid; SABA, short-acting β-agonist; SAMA, short-acting muscarinic antagonist.
Figure 3
Figure 3
Adherence to treatment (TAI questionnaire) according to the type of medication used in the overall population. Note: LABA, LAMA, LABA/LAMA, ICS, ICS/LABA, ICS/LAMA/LABA, and ICS/LAMA could be used alone or in combination with SABA or SAMA. Abbreviations: TAI, Test of Adherence to Inhalers; LABA, long-acting β-agonist; LAMA, long-acting muscarinic antagonist; ICS, inhaled corticosteroid; SABA, short-acting β-agonist; SAMA, short-acting muscarinic antagonist.
See this image and copyright information in PMC

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