The REG 2016 Annual Summit (Respiratory Effectiveness Group) on April 15–16 in Lyon, France, attracted several speakers who emphasized the need for more research into the nature and effectiveness of treatments for chronic obstructive pulmonary disease (COPD) in the real world.
According to the World Health Organization (WHO), 6 percent of all deaths worldwide in 2012 were related to COPD, and over 65 million people have moderate-to-severe COPD. According to the COPD Foundation, the quality of life of COPD patients can improve dramatically if complications and hospitalizations were prevented. This proactive approach would also decrease healthcare costs by 40 percent.
Dr. Alan Kaplan, from Ontario, Canada, was a plenary speaker at REG 2016, and spoke about prevention medicine’s potential to improve COPD patient management services. The researcher suggested that doctors need to interpret guidelines together with all available sources of evidence to treat patients on an individual basis, depending on their condition. Many abstracts submitted to the conference tended toward this direction of a more holistic and comprehensive approach.
Two prize-winning abstracts, which will be published in an upcoming issue of the Journal of Thoracic Disease, were recognized. One, titled “Effect of beta blockers on the Risk of COPD exacerbations” and presented by Lies Lahousse, won the “implications for clinical practice” award, according to a press release. The study suggested that beta blockers – which are mainly used in the treatment of stress or heart problems, like high blood pressure or angina – may also have a beneficial effect in COPD management.
The research study recorded the health data of 1,621 COPD patients from the Rotterdam Study, and explored the effect of beta-blockers on time to COPD exacerbations in patients with and without heart failure.
Although beta blockers are thought to tighten the airways’ muscles, previous research has suggested that their use in COPD could be beneficial for patients. The study aimed to explore this link, and improve the scientific community’s understanding on its potential benefit for COPD-related exacerbations.
The study’s results showed that cardio-selective beta-blockers seemed to reduce the relative risk of COPD exacerbations by 21 percent, and that the benefits substantially increased for heart failure patients, with a 55 percent risk reduction.
The second award-winning abstract, of the best poster presentation at REG 2016, was titled “Comparative Effectiveness of Prescribing Similar versus Dissimilar Inhalers for COPD Therapy,” and authored by Bosnic-Anticevich and others. The study explored the challenges that COPD patients face when they try to find effective ways to take their inhaled medications.
The study included 52,817 patients from the UK Optimum Patient Care Research Database (OPCRD). Most patients (73 percent) were prescribed two inhaler device types, particularly among those with severe types of COPD. The study characterized patients prescribed similar inhalers such as multiple aerosol or multiple dry-powders – or dissimilar inhalers like combinations of the previous examples – and the potential clinical or demographic characteristics that inform prescribing decisions.
The historical cohort study included potential issues that may arise when patients need to take more than one type of inhaler for different COPD medications, which requires them to master multiple, dissimilar inhalation and dose preparation steps. The researchers found that prescribing short-acting beta-agonists (SABA) was actually the biggest contributor for the prescription of dissimilar inhalers, and are now calling for further work to assess the implications of these medical behaviors on real-world clinical outcomes.
Several research studies presented and debated at the REG 2016 Annual Summit highlighted the need to answer questions regarding best practices in COPD management in the real-world context. Organizations such as the Respiratory Effectiveness Group were praised for their work and promotion of these meetings, where international experts can access real data to address these evidence gaps and help clinicians make more informed choices in the future.
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