Perceptions and Usage of Long-Acting Bronchodilators in COPD among Indian Physicians: PATTERN Study

Abstract Background: Bronchodilators are vital in chronic obstructive pulmonary disease (COPD) management as they relieve bronchial obstruction and airflow limitation, decrease hyperinflation, and, thereby improve patient outcomes. Understanding “real-world” practice is crucial in planning effective guidelines for COPD management. Materials and Methods: Physician perceptions and practices related to the use of long-acting bronchodilators in the management of COPD in India were evaluated using a self-reported questionnaire-based survey. Results: A total of 322 physicians participated in this survey. According to 93% of physicians, most patients with COPD had an mMRC score of grade 2 or higher. Approximately 63% of physicians reported that the majority of their patients with COPD had one or two exacerbations every year, whereas 16% of physicians reported more than two exacerbations per year. Long-acting dual bronchodilators (long-acting muscarinic antagonists [LAMA] + long-acting beta agonists [LABA]) were preferred as the first-line therapy by only 43% of physicians. Inhaled corticosteroids (ICS)/LABA/LAMA triple therapy was the most preferred (39%) first-line therapy for clinical maintenance of patients with COPD at high risk of exacerbation. LABA/LAMA was the preferred therapy for GOLD B, C, and D categories of patients by 44%, 32%, and 45% of the physicians, respectively. Indacaterol/glycopyrronium was the preferred LABA/LAMA combination in terms of effective symptom relief, reduced COPD exacerbation rates, and safety. Conclusion: Despite receiving treatment, many patients still experience a substantial degree of breathlessness and exacerbations, probably due to the underutilization of bronchodilator therapy. The limited application of the LABA/LAMA combination is concerning. Measures to improve the management of COPD and related morbidity in India are vital for a better quality of life for the patients.