Pharmacotherapeutic management of COPD patients in Greece--adherence to international guidelines.
BACKGROUND
International guidelines for Chronic Obstructive Pulmonary Disease (COPD) propose the most cost-effective management of the disease. However, the management of COPD differs between countries and between clinics within the same country.


OBJECTIVE
To examine prescription trends for COPD by Lung Specialists (LS) and Primary Care Physicians (PCP) in Greece and to study prescription adherence to international guidelines.


METHODS
A retrospective analysis of COPD prescriptions, obtained from pharmacies located all over the country, was performed between 1997 and the beginning of 2003. The data collected were compared with those of other European countries. A subgroup analysis was carried out for prescriptions issued by PCP and LS.


RESULTS
Between 1997 and 2003, LS and PCP used different pharmacological interventions for the management of COPD. Only the LS prescriptions showed a tendency to guideline adherence. Differences in preferences for different pharmacological drug classes were noted. Thus, LSs were found to generally prefer inhaled corticosteroids (ICSs), followed by anticholinergic drug + a beta(2)-short-acting agonist combinations, long-acting beta(2)-agonists, xanthines, short-acting beta(2)-agonists and expectorants. In contrast, PCPs used mostly short-acting beta(2)-agonists followed by xanthines, ICSs, expectorants, anticholinergic drug + beta(2)-short-acting agonist combinations and long-acting beta(2)-agonists.


CONCLUSIONS
It appears that compliance to international COPD management-guidelines in force at the time of the study increased between 1997 and 2003 only for LSs but not for PCPs.
Tsagaraki
V
V
School of Pharmacy, Laboratory of Biopharmaceutics and Pharmacokinetics, University of Athens, Athens, Greece.
Markantonis
S L
SL
Amfilochiou
A
A
D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005194:Family Practice; D006115:Greece; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008511:Medicine; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D013038:Specialization
D001993:Bronchodilator Agents