COPD Medication Regimens Linked To Disease Severity and Comorbidities

Patients with chronic obstructive pulmonary disease (COPD) often require complex medication regimens that are associated with significant disease severity, comorbidities, and multidimensional indices, according to a study.

A study published in International Journal of Chronic Obstructive Pulmonary Disease examined the link between the medication burden of COPD with the clinical outcomes and comorbidities through a cross-sectional study with 222 COPD patients. The researchers conducted clinical assessments of the participants through recording the demographic information, lung function, smoking history, medical history, medication use, and dyspnea information. Additionally, the researchers considered a self-reported prior year exacerbation and hospitalization history and patients' health-related quality of life.

The medication regimen complexity index (MRCI), a tool developed to identify and quantify medication regimens through the dosage forms, frequencies and dose administration, was utilized in the study to measure the effects of the COPD medication regimens.

“Furthermore, we sought to determine the contributions of comorbid conditions to complex medication regimens in COPD,” explained the authors. “The 2 hypotheses we tested were that, 1) MRCI would be associated with COPD disease severity and comorbidities, and 2) MRCI may potentially serve as an alternative tool to the existing comorbidity-specific indices and other multidimensional COPD indices.”

The results suggested that the COPD-specific medication regimens were more complex than non-COPD medications. The high MRCI scores for COPD-specific medications was attributed to the complex dosage formulations while the dosing frequency was associated with the non-COPD medications. Furthermore, the high complexity levels of COPD-specific treatments demonstrated weak associations with lower lung function, 6-minute walking distance, and an increased number of prior year COPD exacerbations and hospitalization.

Higher total MRCI scores or medication counts for all medications were found to be a result of comorbid cardiovascular, gastrointestinal, or metabolic diseases individually. However, the Charlson Comorbidity Index and the COPD-specific comorbidity test revealed the most significant degree of correlation with the total MRCI score.

“This study illustrated that patients with COPD face dual disadvantages with medication regimen complexity as a result of, first, the complex dosage formulations of their COPD medications and, second, the multiple dosing frequencies of non-COPD medications they may take for their comorbid diseases,” the authors wrote. “Clinicians need to carefully consider all aspects of the disease burden of COPD patients together with the multiple aspects of their pharmacotherapy to identify ways of reducing medication regimen complexity in order to improve treatment adherence, achieve better treatment outcomes, and reduce potential adverse drug events.”

The researchers called for further studies to investigate the benefits of examining the effects of modifying the medication regimen complexity for outcomes including adherence, patient satisfaction, health status, and adverse drug events. Because COPD patients with multiple comorbidities, researchers should be working to discover new ways of reducing the burden of treatment, according to the study.