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Change in asthma and COPD prescribing by Italian general practitioners between 2006 and 2008.

AIMS
To explore the trend in prescribing of drugs classified within the R03 therapeutic pharmacological subgroup (drugs for obstructive airway diseases) of the Anatomical Therapeutic Chemical (ATC) classification.


METHODS
Comparison of GP-collected data on physician-patient contacts and drug prescriptions for asthma and COPD in 2006 and 2008.


RESULTS
Compared to 2006, in 2008 patients with COPD were prescribed more long-acting bronchodilators; use of tiotropium increased, whilst use of long-acting β2-agonists (LABAs) and short-acting antimuscarinic agents decreased. However, 55.9% of patients in 2006, and 47.8% in 2008, received an inhaled corticosteroid (ICS), mainly as a LABA/ICS fixed combination inhaler. Compared to 2006, in 2008 there were increased prescriptions of LABA/ICS fixed combination inhalers for asthma, but only 54.5% of all prescriptions included an ICS. This could explain the large use of short-acting β2-agonists, a marker of poor asthma control. Remarkably, LABA/ICS fixed combination inhalers were prescribed more frequently in COPD than in asthma.


CONCLUSIONS
Our data indicate that adherence to guidelines is still low. Patients with asthma and COPD are undertreated by Italian GPs, with a trend to a change in COPD prescribing likely driven by new scientific information.