Treatment Attitudes and Practices
Only 61% of patients with COPD reported that they were taking any prescription medicine for their condition; another 17% said they had taken prescription medicines in the past year but were not doing so at the time of the interview (Figure 24).
Doctors rated bronchodilators (40%) and inhaled corticosteroids (34%) as very effective in the treatment of mild to moderate COPD. The role of these anti-inflammatory medications in COPD therapy is not well-defined, and they are not yet approved for COPD in the United States. However, clinical trials are underway. Ninety-nine percent of doctors interviewed said that bronchodilators were somewhat effective for mild to moderate COPD (Figure 25). Similarly, nine out of 10 (89%) agreed that inhaled corticosteroids were somewhat effective for mild to moderate COPD.
Substantial proportions of doctors reported that they would normally prescribe the following to "all or most" newly diagnosed patients (Figure 26):
- Short-acting beta2-agonists (67%)
- Inhaled corticosteroids (62%)
- Anticholinergics (47%)
- Long-acting beta2-agonists (48%)
Virtually all doctors (96%) said they would normally prescribe flu vaccinations to all or most newly diagnosed patients with moderate, or Stage 2, COPD (Figure 26).
The percentage of patients with COPD who reported taking specific types of prescription medicines for their condition was substantially less than the proportion of physicians who said they would prescribe these medications for moderate COPD. One notable disparity: while about the same proportion of physicians said they would recommend long-acting beta2-agonists (47%) as often as anticholinergics (48%), substantially fewer patients reported taking long-acting beta2-agonists (7%) than anticholinergics (19%) in the past year (Figure 27).
Patient attitudes toward treatment, which may be informed by the
medications they are taking, suggested that patients perceived a "treatment burden" in addition to a disease burden (Figure 28):
- 31% said their medication schedule made it difficult to lead an active life.
- 62% said that taking so many medicines was inconvenient, and 57% said they would be better about taking their medicine if it were more convenient.
- 89% agreed that twice-a-day dosing would be more convenient than
3 to 4 times a day.
