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Analysis of the Time Taken to Triple Therapy (NOVARTIS)

Conditions
COPD
Registration Number
NCT01786720
Lead Sponsor
Research in Real-Life Ltd
Brief Summary

The proposed study will evaluate (for newly diagnosed Chronic Obstructive Pulmonary Disease (COPD) patients)the time taken to prescription of triple therapy by aiming to answer these following research questions:

1. The percentage of patients prescribed triple therapy, and when they first started receiving triple therapy.

2. For patients prescribed triple therapy, the time taken to triple therapy from initial diagnosis of COPD.

3. The variation in treatment pathways.

4. The factors associated with time taken to triple therapy.

Detailed Description

Triple therapy consists of long-acting beta agonist (LABA) + inhaled corticosteroids (ICS) + long-acting muscarinic antagonist (LAMA) and typically should be reserved for patients who have severe to very severe (FEV1 \<50%) COPD symptoms or for patients who have two or more exacerbations per year. However previous research from RiRL indicate that 50% of patients at GOLD stage II (moderate) receive ICS of which half were on triple therapy.

To allow for multiple analysis regarding the factors that influence the likelihood of being prescribed triple therapy, a bespoke COPD dataset will be created to include:

1. Disease severity markers:

2. Confirmation of a COPD diagnosis at initial date of COPD diagnosis

3. Standard co-morbidities fields

4. Demographic fields

This retrospective, observational study using data of COPD patients will assess treatment pathways (changes/step up) from initial date of COPD diagnosis with the prescription of triple therapy as the endpoint.

Specific questions that will be asked are:

1. Does the percentage of COPD patients prescribed triple therapy vary dependent on time of initial date of COPD diagnosis?

2. Does the time taken to the prescription of triple therapy vary dependent on initial date of COPD diagnosis?

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20154
Inclusion Criteria
  • Aged ≥40 years at initial date of COPD diagnosis
  • COPD diagnosis with Quality Outcome Framework (QoF) approved read code
  • has spirometry data supportive of a COPD diagnosis in the 5 years around initial date diagnosis of COPD (FEV1 % predicted)
  • Patient has one year of data prior to initial date of COPD diagnosis
  • Patient has a minimum of two years of data post initial date of COPD diagnosi
Exclusion Criteria
  • Patients whose initial date of COPD diagnosis is before 1997

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Triple Therapy Status1 year

The proportion of patients prescribed triple therapy and whether they were prescribed it prior to, at, or after initial date of COPD diagnosis.

Initial date of COPD diagnosis1 year

The date that patients were initially diagnosed with COPD. Categorised into cohorts- 1997-2001, 2002-2006, 2007-2010.

Secondary Outcome Measures
NameTimeMethod
Lung function grade1 year

Patient lung function grade, calculated by GOLD I, II, III, IV criteria.

Asthma Diagnosis1 year

Proportion of patients with a co-morbid asthma diagnosis

COPD patient group1 year

Patients COPD patient group, calculated by GOLD A, B, C, D criteria dependent on symptoms and risk of patient.

COPD exacerbations (Clinical experience based)1 year

Number of the following: (i) Asthma/copd-related\*: a. Hospital attendance / admissions OR b. A\&E attendance OR (ii) GP consultations for lower respiratory related tract infections

Smoking Status1 year

Patient smoking status, taken from routine and questionnaire data

BMI1 year

Patient BMI class

COPD co-morbidities1 year

COPD co-morbidities are identified via Read codes that are recorded at any time.

Co-morbidities are: GERD, Rhinitis, Heart Failure, Ischaemic Heart Disease, Diabetes, Osteoporosis, Chronic Renal Failure, Chronic Kidney Disease and Anxiety-Depression

Trial Locations

Locations (1)

Research in Real Life Ltf

🇬🇧

Cambridge, United Kingdom

Research in Real Life Ltf
🇬🇧Cambridge, United Kingdom

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