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Trends and Factors Associated with Nebulized Therapy Prescription in Older Adults with Chronic Obstructive Pulmonary Disease from 2008 to 2015
- Source :
- Journal of aerosol medicine and pulmonary drug delivery. 33(3)
- Publication Year :
- 2020
-
Abstract
- Background: Medical management of patients with chronic obstructive pulmonary disease (COPD) includes nebulized therapy as an option for inhalational drug delivery. A broad variety of short- and long-acting bronchodilators and inhaled corticosteroids in the nebulized form are available. Despite this, limited information exists on the pattern and predictors of nebulized prescription. We examined the trend and factors associated with prescription of nebulized therapy among Medicare beneficiaries with COPD. Methods: A retrospective cross-sectional study of 5% Medicare beneficiaries with COPD (n = 66,032) who were enrolled in parts A, B, and D and received nebulized prescription from 2008 to 2015 was conducted. This sample has shown to be representative of the entire fee-for-service Medicare population. The primary outcome was a prescription of nebulized medications. Reliever nebulized medications included short-acting beta agonist (SABA), short-acting muscarinic agents (SAMAs), and a combination of SABA and SAMA, while maintenance nebulized medications included long-acting beta agonists, long-acting muscarinic agents, and corticosteroid solutions as well as combinations of these agents. The secondary outcome was prescription of other inhaler respiratory medications not administered with a nebulizer. Results: Overall, 38.9% patients were prescribed nebulized medication and their prescription significantly declined from 42.4% in 2008 to 35.1% in 2015, majority of which was related to decreased prescriptions of nebulized relievers. Factors associated with the prescription of nebulized medications include female gender (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02-1.09), dual eligibility or low-income subsidy beneficiaries (OR = 1.49; CI = 1.44-1.53), hospitalization for COPD in the previous year (OR = 1.29; CI = 1.25-1.34), home oxygen therapy (OR = 2.29; CI = 2.23-2.36), pulmonary specialist visit (OR = 1.24; CI = 1.20-1.27), and moderate (OR = 1.61; CI = 1.57-1.65) or high (OR = 1.52; CI = 1.46-1.59) severity of COPD. Conclusion: Between 2008 and 2015, prescriptions for nebulized therapy for COPD declined among Medicare beneficiaries, probably related to increase in use of maintenance non-nebulized medications.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
medicine.drug_class
Pharmaceutical Science
Pulmonary disease
Medicare
Pulmonary Disease, Chronic Obstructive
Drug Delivery Systems
Adrenal Cortex Hormones
Internal medicine
Administration, Inhalation
medicine
Humans
Pharmacology (medical)
Medical prescription
Practice Patterns, Physicians'
Aged
Retrospective Studies
Aged, 80 and over
COPD
business.industry
Inhaler
Nebulizers and Vaporizers
Odds ratio
Adrenergic beta-Agonists
medicine.disease
Confidence interval
United States
Bronchodilator Agents
Hospitalization
Nebulizer
Cross-Sectional Studies
Corticosteroid
Female
business
Subjects
Details
- ISSN :
- 19412703
- Volume :
- 33
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of aerosol medicine and pulmonary drug delivery
- Accession number :
- edsair.doi.dedup.....5f292f5fd9b7b3b10305c301242880f6