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The inevitable drift to triple therapy in COPD: an analysis of prescribing pathways in the UK

Overview of attention for article published in International Journal of Chronic Obstructive Pulmonary Disease, October 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#18 of 916)
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • High Attention Score compared to outputs of the same age and source (96th percentile)

Mentioned by

news
2 news outlets
twitter
6 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
113 Dimensions

Readers on

mendeley
119 Mendeley
Title
The inevitable drift to triple therapy in COPD: an analysis of prescribing pathways in the UK
Published in
International Journal of Chronic Obstructive Pulmonary Disease, October 2015
DOI 10.2147/copd.s91694
Pubmed ID
Authors

David Price, Guy Brusselle, Kevin Gruffydd-Jones, Marc Miravitlles, Rebecca Stewart, Michael Baldwin, Dorothy Keininger, Rupert Jones

Abstract

Real-world prescription pathways leading to triple therapy (TT) (inhaled corticosteroid [ICS] plus long-acting β2-agonist bronchodilator [LABA] plus long-acting muscarinic antagonist) differ from Global initiative for chronic Obstructive Lung Disease [GOLD] and National Institute for Health and Care Excellence treatment recommendations. This study sets out to identify COPD patients without asthma receiving TT, and determine the pathways taken from diagnosis to the first prescription of TT. This was a historical analysis of COPD patients without asthma from the Optimum Patient Care Research Database (387 primary-care practices across the UK) from 2002 to 2010. Patient disease severity was classified using GOLD 2013 criteria. Data were analyzed to determine prescribing of TT before, at, and after COPD diagnosis; the average time taken to receive TT; and the impact of lung function grade, modified Medical Research Council dyspnea score, and exacerbation history on the pathway to TT. During the study period, 32% of patients received TT. Of these, 19%, 28%, 37%, and 46% of patients classified as GOLD A, B, C, and D, respectively, progressed to TT after diagnosis (P<0.001). Of all patients prescribed TT, 25% were prescribed TT within 1 year of diagnosis, irrespective of GOLD classification (P=0.065). The most common prescription pathway to TT was LABA plus ICS. It was observed that exacerbation history did influence the pathway of LABA plus ICS to TT. Real life UK prescription data demonstrates the inappropriate prescribing of TT and confirms that starting patients on ICS plus LABA results in the inevitable drift to overuse of TT. This study highlights the need for dissemination and implementation of COPD guidelines to physicians, ensuring that patients receive the recommended therapy.

Twitter Demographics

The data shown below were collected from the profiles of 6 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 119 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 1 <1%
Unknown 118 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 26 22%
Other 18 15%
Student > Bachelor 15 13%
Student > Master 14 12%
Student > Postgraduate 8 7%
Other 24 20%
Unknown 14 12%
Readers by discipline Count As %
Medicine and Dentistry 66 55%
Pharmacology, Toxicology and Pharmaceutical Science 15 13%
Nursing and Health Professions 5 4%
Biochemistry, Genetics and Molecular Biology 4 3%
Agricultural and Biological Sciences 2 2%
Other 6 5%
Unknown 21 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 21. 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 09 December 2015.
All research outputs
#337,107
of 7,383,397 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#18
of 916 outputs
Outputs of similar age
#18,104
of 241,092 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#3
of 84 outputs
Altmetric has tracked 7,383,397 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 916 research outputs from this source. They receive a mean Attention Score of 4.2. This one has done particularly well, scoring higher than 98% of its peers.
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 241,092 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 84 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 96% of its contemporaries.