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An evaluation of early medication use for COPD: a population-based cohort study

Overview of attention for article published in International Journal of Chronic Obstructive Pulmonary Disease, December 2016
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3 tweeters

Citations

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Readers on

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29 Mendeley
Title
An evaluation of early medication use for COPD: a population-based cohort study
Published in
International Journal of Chronic Obstructive Pulmonary Disease, December 2016
DOI 10.2147/copd.s123643
Pubmed ID
Authors

Jamie Falk, Natalia Dik, Shawn Bugden

Abstract

The aim of this study was to evaluate the first initiation, sequence of addition, and appropriate prescribing of COPD medications in Manitoba, Canada. A population-based cohort study of COPD medication use was conducted using administrative health care data (1997-2012). Those aged ≥35 years with COPD based on three or more COPD-related outpatient visits over a rolling 24-month window or at least one COPD-related hospitalization were included. The first medication(s) dispensed on or after the date of COPD diagnosis were determined based on pharmacy claims. The next medication(s) in sequence were determined to be additions or switches to the previous regimen. Evaluation of guideline-based appropriateness to receive inhaled corticosteroids (ICS) was based on exacerbation history and past medication use. Of 13,369 patients dispensed COPD medications after diagnosis, 66.0% were dispensed short-acting bronchodilators as first medications. Although long-acting bronchodilators alone were uncommonly used as first or subsequent medications, ICS were dispensed as first medications in 28.2% of patients. Over the study period, use of short-acting bronchodilators as first medications declined from 70.6% to 59.4% (P<0.0001), whereas the use of ICS as a first medication increased from 23.5% to 34.4% (P<0.0001). Dispensation of an ICS plus a long-acting β-agonist increased dramatically from 1.2% to 27.3% (P<0.0001). By the end of the study period, the majority of patients (53.3%) were being initiated on two or more medications. Of 5,823 patients dispensed an ICS, 52.4% met Canadian guideline criteria for initiating an ICS, whereas 0.3% met Global Initiative for Chronic Obstructive Lung Disease guideline criteria. The use of first-line medications has declined over time, replaced primarily by combination inhalers prescribed early without prior trials of appropriate next step medications. This, along with an increasingly predominant use of multiple first medications, indicates a significant degree of medication burden in this already complex patient population.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 29 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 6 21%
Student > Master 5 17%
Student > Bachelor 3 10%
Researcher 2 7%
Student > Postgraduate 2 7%
Other 5 17%
Unknown 6 21%
Readers by discipline Count As %
Medicine and Dentistry 8 28%
Nursing and Health Professions 4 14%
Pharmacology, Toxicology and Pharmaceutical Science 3 10%
Agricultural and Biological Sciences 2 7%
Business, Management and Accounting 1 3%
Other 3 10%
Unknown 8 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 August 2017.
All research outputs
#6,935,007
of 11,595,461 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#781
of 1,355 outputs
Outputs of similar age
#164,116
of 323,962 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#55
of 91 outputs
Altmetric has tracked 11,595,461 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,355 research outputs from this source. They receive a mean Attention Score of 4.7. This one is in the 37th percentile – i.e., 37% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 323,962 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 91 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.