Prevalence of inhaled corticosteroid use among patients with chronic obstructive pulmonary disease: a survey

OBJECTIVE: To determine the extent of inhaled corticosteroid use among patients with chronic obstructive pulmonary disease (COPD). DESIGN: Review of medical records. SETTING: Tertiary-care university teaching hospital. PATIENTS: Seventy-two consecutive patients prescribed an inhaled corticosteroid during hospitalization. INTERVENTION: None. MEASUREMENTS: Patient demographics, inhaled corticosteroid regimen, respiratory diagnosis, and inhaled corticosteroid use before and during hospitalization. RESULTS: The majority of patients (85%) were receiving their prescribed corticosteroid inhaler prior to admission. Beclomethasone dipropionate 250 micrograms/puff was the most commonly prescribed inhaled corticosteroid formulation accounting for 43% of the total corticosteroid inhaler orders. COPD was the most common respiratory diagnosis (43%) associated with inhaled corticosteroid use, followed by asthma (37%), COPD/asthma (13%), and no diagnosis (7%). During the study period, the proportion of all hospitalized patients with COPD who also received inhaled corticosteroid prescriptions (35%) was not significantly different from all hospitalized patients with asthma who received inhaled corticosteroid prescriptions (33%). CONCLUSIONS: The rate of inhaled corticosteroid use far exceeds the rate expected among the general population of patients with COPD. Educational intervention is needed to encourage compliance with published guidelines for the management of COPD.