Treatment Patterns in Asthma- Chronic Obstructive Pulmonary Disease Overlap Syndrome

Background: Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is a complex disease entity with limited guidance surrounding medication therapy. Objective: To evaluate a patient population with possible ACOS and their medication regimen based on the Global Initiative for Asthma and Global Initiative for COPD joint statement for ACOS. Methods: This was a retrospective study based at a large clinical practice within a school of medicine. The sample included adults 40 to 85 years old who had an active concurrent diagnosis of asthma and COPD. Patients were considered to have likely inconsistent therapy (only preventive, no rescue medication), inconsistent therapy (neither preventive nor rescue medication), and likely consistent therapy (both preventive and rescue medication or rescue medication alone). Results: A total of 513 patients were included the study. The majority of the sample were female (75%) and white (87.1%), with an average age of 61 years. About 7% of patients had likely inconsistent therapy, whereas 7.7% had inconsistent therapy to control their airway disease. Never smokers were more likely than former smokers to have inconsistent therapy (adjusted odds ratio [OR] = 4.54; CI = 1.86-11.04). Adults 65 years and older were more likely than those aged 40 to 49 years to be in the likely inconsistent therapy group (adjusted OR = 4.01; CI = 1.04-15.34). Patients without any comorbid conditions were more likely than those with 2 or more comorbid conditions to be in the likely inconsistent group (adjusted OR = 3.50; CI = 1.39-8.77). Conclusion: As the disease definition and treatment recommendations evolve, future studies should continue to monitor ACOS treatment patterns and outcomes.