OBJECTIVES: To examine the prescribing pattern of drugs for the treatment of Chronic Obstructive Pulmonary Disease (COPD) in ambulatory care visits and to assess the variation in the prescription of first line of therapy across sex, race and geographic region.
METHODS: Data of 2006–2007 National Ambulatory Medical Care Survey (NAMCS) and outpatient files of National Hospital Ambulatory Medical Care Survey (NHAMCS) were analyzed. Sample data was weighted to provide US national estimates. Adults more than 25 years of age were included in the study and COPD visits were identified (ICD-9-CM: 491,492,496). First line of therapy was defined as prescription of either beta-agonist or anticholinergics. Descriptive weighted analysis was performed to examine the prescribing pattern of drugs and multivariate logistic regression using complex survey design was conducted to identify variation for first line of therapy across sex, race and region, while controlling for age, tobacco use, insurance, metropolitan area, and region.
RESULTS: In 2006–2007, COPD accounted for 70.25 million (95% CI: 60.69–79.81) ambulatory care visits by adult patients, representing 3.3% of the total ambulatory visits. Of these visits, majority were made by females (59.14%), whites (87.31%) and living in the southern region (44.78%). COPD medications were only prescribed in 42.13% of the visits. Highly prescribed medications were bronchodilators (34.33%), followed by combination therapy (9.66%) and inhaled corticosteroids (2.71%). First line of therapy was prescribed at 25.17% (95% CI: 21.62–28.72) visits: 19.16% visits received beta-agonist and 11.84% visits received anticholinergics. No variation was found across sex, race, and region for the prescription of first line of therapy for COPD.
CONCLUSIONS: Bronchodilators were highly prescribed medication for COPD in outpatient visits. The first line of therapy did not vary significantly across sex, race and region for COPD.
