title: Factors associated with the prescription of inhaled corticosteroids in GOLD group A and B patients with COPD - subgroup analysis of the Taiwan obstructive lung disease cohort.
abstract: OBJECTIVE
  The overprescription of inhaled corticosteroids (ICS) in the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A and B patients with chronic obstructive pulmonary disease (COPD) is not uncommon in clinical practice. The aim of this study was to explore the factors associated with the use of ICS in these patients.
  
  
  METHODS
  The Taiwan obstructive lung disease (TOLD) study was a retrospective, observational nationwide survey of COPD patients conducted at 12 hospitals (n=1,096) in Taiwan. Multivariate logistic regression models were used to explore the predictors of ICS prescription in GOLD group A and B patients.
  
  
  RESULTS
  Among the group A (n=179) and group B (n=398) patients, 198 (34.3%) were prescribed ICS (30.2% in group A and 36.2% in group B, respectively). The wheezing phenotype was present in 28.5% of group A and 34.2% of group B patients. Wheezing was the most significant factor for an ICS prescription in group A (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.14-4.75; P=0.020), group B (OR, 1.93; 95% CI, 1.24-2.99; P=0.004), and overall (OR, 2.04; 95% CI, 1.40-2.96; P<0.001). The COPD assessment test score was also associated with an ICS prescription in group B (OR, 1.04; 95% CI, 1.00-1.07; P=0.038).
  
  
  CONCLUSIONS
  About one-third of the GOLD group A and B patients with COPD in Taiwan are prescribed ICS. Our findings suggest that wheezing and COPD assessment test score are related to the prescription of ICS in these patients.
authors.affiliation: Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Wei
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ping-Hung
authors.initials: PH
authors.lastname: Kuo
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
authors.affiliation: Department of Internal Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Tao
authors.affiliation: Division of Thoracic Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Chemical Engineering and Materials Science, Yuan-Ze University, Taoyuan, Taiwan.
authors.forename: Shih-Lung
authors.initials: SL
authors.lastname: Cheng
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chao-Hsien
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Taipei, Taiwan.
authors.forename: Yao-Kuang
authors.initials: YK
authors.lastname: Wu
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Ning-Hung
authors.initials: NH
authors.lastname: Chen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University and China Medical University Hospital, Taichung, Taiwan.
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: Division of Chest Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Jeng-Yuan
authors.initials: JY
authors.lastname: Hsu
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Lin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Wang
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification* / Q000188:drug therapy*; D012135:Respiratory Sounds / Q000503:physiopathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents
keywords: COPD assessment test; chronic obstructive pulmonary disease; inhaled corticosteroids; wheezing