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Taraneh Bahremand,1 Mahyar Etminan,2 Nardin Roshan-Moniri,1 Mary A De Vera,1 Hamid Tavakoli,1 Mohsen Sadatsafavi1 1Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada; 2Department of Ophthalmology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, CanadaCorrespondence: Mohsen SadatsafaviFaculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, CanadaEmail msafavi@mail.ubc.caBackground: In contemporary guidelines for the management of Chronic Obstructive Pulmonary Disease (COPD), the history of acute exacerbations plays an important role in the choice of long-term inhaled therapies. This study aimed at evaluating population-level trends of filled inhaled prescriptions over the time course of COPD and their relation to the history of exacerbations.Methods: We used administrative health databases in British Columbia, Canada (1997– 2015), to create a retrospective incident cohort of individuals with diagnosed COPD. We quantified long-acting inhaled medication prescriptions within each year of follow-up and documented their trend over the time course of COPD. Using generalized linear models, we investigated the association between the frequent exacerbator status (≥ 2 moderate or ≥ 1 severe exacerbation(s) in the previous 12 months) and filling a prescription after a physician visit.Results: 132,004 COPD patients were included (mean age 68.6, 49.2% female). The most common medication class during the first year of diagnosis was inhaled corticosteroids (ICS, used by 49.9%), followed by long-acting beta-2 adrenoreceptor agonists (LABA, 31.8%). Long-acting muscarinic receptor antagonists (LAMA) were the least commonly prescribed (10.4%). ICS remained the most common prescription throughout follow-up, being used by approximately 50% of patients during each year. 39.0% of patients received combination inhaled thera

Hamid Tavakoli1, Kate M Johnson1, J Mark FitzGerald2, Don D Sin3, Andrea S Gershon4, Tetyana Kendzerska5, Mohsen Sadatsafavi1,2 On behalf of the Canadian Respiratory Research Network1Respiratory Evaluation Sciences Program, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada; 2Institute for Heart and Lung Health, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; 3Centre for Heart Lung Innovation (the James Hogg Research Centre), St. Paul’s Hospital, Vancouver, British Columbia, Canada; 4Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; 5Department of Medicine, Division of Respirology, The Ottawa Hospital Research Institute/University of Ottawa, Ottawa, Ontario, CanadaCorrespondence: Hamid TavakoliFaculty of Pharmaceutical Sciences, University of British, Columbia, Vancouver Campus, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, CanadaTel +1 604 723 4923Fax +1 604 875 5179Email Hamid.tavakoli@ubc.caBackground: The patterns of medication use in chronic obstructive pulmonary disease (COPD) may change over time due to the availability of new medications, updates in guideline-based recommendations, and changes in patient and care provider preferences.Objectives: To document population-level trends of filled prescriptions and costs for major classes of inhaled COPD therapies.Method: We used administrative health databases of the province of British Columbia, Canada, from 1997 to 2015, to create a retrospective cohort of COPD patients. We documented the percentage of patients receiving major inhaled COPD-related medications, including short-acting beta-2 adrenoreceptor agonists (SABA), long-acting beta-2 adrenoreceptor agonists (LABA), inhaled corticosteroids (ICS), short-acting muscarinic receptor antagonists (SAMA), and long-acting muscarinic receptor antagonists