Author:
Juntunen Pekka,Salmela Petri,Pakkasela Johanna,Karjalainen Jussi,Lehtimäki Lauri
Abstract
Abstract
Background
Asthma and chronic obstructive pulmonary disease (COPD) are common diseases mostly treated in primary care. However, the usage patterns of drugs for obstructive airway diseases (R03 drugs) at the national level are not known.
Objective
The aims of this study were to describe (1) for which diagnoses each class of R03 drugs were used, (2) the usage pattern of different drug classes for asthma and COPD, and (3) how often these medications were used without a diagnosis of asthma or COPD in Finland.
Methods
We sent questionnaires that included questions on physician-diagnosed asthma and COPD to a random sample of 2000 Finnish subjects who had been dispensed R03 medications in the previous year. Details of R03 medications dispensed were retrieved from national registries.
Results
Altogether, 803 subjects (40.6%) responded. Of these, 61.6% had asthma, 5.7% had both asthma and COPD, 5.1% had COPD, and 27.5% had neither asthma nor COPD. Among subjects with asthma or asthma and COPD, inhaled corticosteroids (ICS) were the most frequently dispensed class of drugs (93.7% and 97.8%, respectively). Even among subjects with COPD, ICS were dispensed as frequently (68.3%) as long-acting bronchodilators (70.7%). Antileukotrienes were dispensed mainly to asthmatic individuals only (18.4%) but far less frequently than ICS. The use of theophylline and roflumilast was rare.
Conclusions
R03 medications are dispensed far more frequently for asthma than for COPD and often also for subjects without asthma or COPD. In line with guidelines, asthma is treated mainly with ICS, but there seems to be overuse of ICS for COPD.
Funder
Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital
Hengityssairauksien Tutkimussäätiö
Tampereen Tuberkuloosisäätiö
Tays tukisäätiö
Tampere University
Publisher
Springer Science and Business Media LLC
Reference24 articles.
1. GBD. Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Lond Engl 2020. 2019;396(10258):1204–22.
2. Honkamäki J, Hisinger-Mölkänen H, Ilmarinen P, Piirilä P, Tuomisto LE, Andersén H, et al. Age- and gender-specific incidence of new asthma diagnosis from childhood to late adulthood. Respir Med. 2019;154:56–62.
3. Haahtela T, Tuomisto LE, Pietinalho A, Klaukka T, Erhola M, Kaila M, et al. A 10 year asthma programme in Finland: major change for the better. Thorax. 2006;61(8):663–70.
4. Kinnula VL, Vasankari T, Kontula E, Sovijarvi A, Saynajakangas O, Pietinalho A. The 10-year COPD Programme in Finland: effects on quality of diagnosis, smoking, prevalence, hospital admissions and mortality. Prim Care Respir J J Gen Pract Airw Group. 2011;20(2):178–83.
5. Working group appointed by the Finnish Medical Society Duodecim, the Finnish Respiratory Society. Chronic obstructive pulmonary disease (COPD). Current Care Guidelines. 2020. Available from: www.kaypahoito.fi Cited 2021.