Pharmaceutical treatment status of patients with COPD in the community based on medical Internet of Things: a real-world study

Abstract

This study aimed to investigate the real-world standardisation and adherence of medical treatment regimens in patients with chronic obstructive pulmonary disease (COPD) in the community for making future management strategy. The follow-up data and treatment information of patients with COPD, which were collected through the Management Information Center of COPD (MICCOPD) in 21 community health service centres in Songjiang District, a countryside region of Shanghai. Concordance between the pharmaceutical treatment plan and recommendation of 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report during the follow-up management period, as well as the medication adherence by patients,were analysed. Out of the 2044 patients diagnosed with COPD, 814 patients (39.8%) who had an initial record of medication use were found to meet the inclusion criteria. The most common medication regimens were long-acting beta-agonist plus inhaled corticosteroids (35.9%) and oral bronchodilators (41.9%). Among these 814 patients, 45.7%, 38.0%, 31.6% and 14.6% adhered to the treatment after 6, 12, 18 and 24 months of follow-up, respectively. The concordance rate with the regimens recommended by the 2017 GOLD guidelines was 35.5% at baseline, 35.5% at 6 months, 32.7% at 12 months, 35.4% at 18 months and 37% at 24 months. The compliance and guideline consistency rates of patients with COPD in the community under the management of general practitioners need to be improved. Enhancing general practitioner proficiency in the prevention and management of COPD and increasing patient awareness of the condition, are crucial standardising and improving adherence to initial and follow-up COPD treatments.

Fig. 1

Study flow chart.

Fig. 2. Distribution of specific medication regimens for all patients.

A GOLD group A. B GOLD group B. C GOLD group C. D GOLD group D.

Fig. 3. Consistency of initial drug therapy with recommended guidelines.

a According to the comprehensive assessment grouping criteria, the consistency of the initial drug treatment regimen with the 2017 GOLD guideline recommended regimen. b Based on sex and age as grouping criteria, the consistency of the initial drug treatment regimen with the 2017 GOLD guideline recommended regimen.

Fig. 4

Proportion of patients adhering to medication.

Fig. 5

Proportion of patients’ consistency rate with the guideline.