Why focus on individualized therapy?
Every day, you weigh the roles of short-acting and long-acting therapies to make choices that may help your COPD patients achieve desirable clinical outcomes. Regular assessment enables you to monitor your patients’ symptom control, disease progression, and other physical and cognitive changes to help you individualize therapy.1
Scroll through the following common “myth-conceptions” about the roles of rescue and maintenance therapies for COPD.
Is an individualized approach to COPD therapy useful?
myth
“Long-acting maintenance therapy is generally unnecessary for patients with COPD who are already on short-acting therapy.”
fact
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria recommend an individualized approach to treatment, including the initiation of long-acting maintenance therapy for most patients with COPD.1
For hospitalized patients, it is recommended that initiation of maintenance therapy with long-acting bronchodilators begin as soon as possible prior to hospital discharge.1
Why not adjust therapy?
myth
“When patients’ symptoms aren’t adequately controlled by their current COPD therapy, it’s always best to add an additional therapy to achieve control.”
fact
An additional therapy is not always recommended for patients with inadequately controlled COPD.1 The Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria suggest that an adjustment in therapy be considered, when necessary, following review and assessment of a patient’s symptoms, exacerbations, inhaler technique, and treatment adherence.1
Adjustments in therapy that may be considered are:
- escalating therapy1
- de-escalating therapy1
- switching inhaler device or molecule1
Each follow-up visit should include monitoring of a patient’s response to therapy, inhaler technique,* and adherence.1
*
The impact of device choice on clinical outcomes has not been demonstrated.
What are considerations about the delivery device at hospital discharge?
myth
“Treatment delivery device is not an important factor when choosing therapy for a patient at hospital discharge.”
fact
A patient’s ability to use certain delivery devices may be an important consideration when selecting a COPD treatment, especially upon discharge after an exacerbation.1,2 The use of a handheld device can be influenced by limitations in physical dexterity and/or airflow.3,4*
Peak inspiratory flow rate (PIFR) can be used to assess ability to generate adequate inspiratory flow.2* In a study of patients with severe COPD that was published in the American Journal of Respiratory and Critical Care Medicine,† the most common error in inhaler use during the month following hospital discharge involved low inhalation flow (peak inspiratory flow <35 L/min).5*
*
The impact of PIFR and device choice on clinical outcomes has not been established.
†
A prospective observational study in which 244 patients with COPD were given an inhaler with an attached electronic recording device (INCA) at hospital discharge. Mean patient age was 71 years, mean FEV₁ was 1.3 L, and 55% of patients had evidence of mild/moderate cognitive impairment.5
How accessible are nebulizers for most patients?
myth
“Jet nebulizers are not commonly available to patients with COPD.”
fact
Jet nebulizers are widely available and considered to be the standard type of nebulizer.6 Among COPD patients in the United States:
- approximately 45% have a nebulizer at home7*
- most nebulizers are covered by Medicare Part B as durable medical equipment (DME) for at-home use8
It is estimated that several million patients use a nebulizer on a regular basis in the United States (based on the estimated prevalence of COPD).7
*
Data referenced from a 2008 survey.7
References: 1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2021 Report). https://goldcopd.org/2021-gold-reports/. Accessed December 3, 2020. 2. Sharma G, Mahler, DA, Mayorga VM, et al. Prevalence of low peak inspiratory flow rate at discharge in patients hospitalized for COPD exacerbation. Chronic Obstr Pulm Dis. 2017;4(3):217-224. 3. Wise RA, Acevedo RA, Anzueto AR, et al. Guiding principles for the use of nebulized long-acting beta2-agonists in patients with COPD: an expert panel consensus. Chronic Obstr Pulm Dis. 2016;4(1):7-20. 4. Hanania NA, Braman S, Adams SG, et al. The role of inhalation delivery devices in COPD: perspectives of patients and health care providers. Chronic Obstr Pulm Dis.
This website is paid for and content developed by Mylan Specialty L.P., a Viatris Company, and Theravance Biopharma US, Inc.
VIATRIS and the Viatris Logo are trademarks of Mylan Inc., a Viatris Company.
THERAVANCE BIOPHARMA®, THERAVANCE®, and the Cross/Star logo are registered trademarks of the Theravance Biopharma group of companies (in the U.S. and certain other countries).
The Myth-Understood logo is a trademark of Mylan Specialty L.P., a Viatris Company.
© 2021 Viatris Inc. All Rights Reserved. NON-2020-1996 V2
- Privacy Statement
- Copyright and Legal Disclaimer
- Cookie Notice
- California Supplemental Disclosure
- Contact Us
