DOI: 10.36347/sjams.2017.v05i07.040

Pages: 2695-2698

Primary care physicians provide treatment to the majority of patients of COPD in India. Worldwide significant gaps exist between recommendations and actual COPD management in primary care practice. In India there is paucity of data about the outpatient treatment and practice patterns in COPD management in primary care. The aim is to evaluate the outpatient pharmacological treatment choices in primary care practice in management of COPD. We studied the prescriptions details of the already diagnosed and on treatment COPD patients of more than 40 years of age in out patient department. The inhaler devices, inhaled medications, oral medications were physically verified by the authors. The results were tabulated and analyzed on percentage scale. Study included 4287 patients of COPD. 29.5% patients were on inhaled medication and majority 70.5% were on oral medications. 35.8% were prescribed inhaled SABA and ICS combination, 25.9 % LABA and ICS combination, 7.8% SABA and SAAC, 4.1% triple inhaler with ciclesonide, tiotropium and formoterol, 13.5% SABA and 11.3% were prescribed ICS. Among oral medications methylxanthines were prescribed to 30.5%, a combination of oral β-agonists and methylxanthines to 19.8%, oral β-agonists to 15.2%, leukotriene modifiers to 3.6%, steroids to 6.9% and 24.1% were on multiple drugs. Our study concludes that the COPD management in primary care is extremely sub optimal as majority of the patients are being prescribed oral medications instead of inhaled medications and the choices of inhaled medications are also not according to the guidelines.