World Congress on
COPD, Asthma and Lung Health

Dr Chung-Yu Chen research area is comparative safety and effectiveness of medications in special populations such as elderly with chronic conditions (especially cardiovascular disease, COPD, liver diseases, and renal diseases). Multiple challenges exist in conducting comparative effectiveness studies using observational data. Dr Chung-Yu Chen use, promote, and develop/test epidemiology design issues as well as advanced statistical methods to conduct valid observational studies. Substantive areas of interests include cardiovascular drugs, cerebrovascular events and cancer as safety endpoints, and methodological issues in observational studies for comparative effectiveness research including implication and control for various bias (misclassification bias, selection bias, and confounding bias), methods and validity of record linkage to improve data sources, and special methodological issues in medicine.

Patients with COPD have a systemic inflammatory status, and inflammatory cytokines can cause neuron damage and result in neurodegenerative disorders. COPD is one of the comorbidities with increasing evidence of an association with cognitive dysfunction and dementia. [1] COPD patients with dementia increased the severe sepsis, acute respiratory failure and mortality. [2] Therefore, it is currently of great interest to clarify which features predict progression to dementia and identifying modifiable risk factors. The aim of our studies was to investigate whether medication adherence in patients with COPD can decrease the risk of dementia. We retrieved our retrospective study sample from 1 million beneficiaries. In this cohort study, the eligible subjects were patients who received an outpatient diagnosis or discharge diagnosis of COPD (ICD-9-CM codes: 490-492, 496) and were older than 40 years of age between January 1, 1998 and December 31, 2012. Only the first COPD diagnosis was enrolled. We used proportion of days covered (PDC) to evaluate medication adherence in the COPD patients, which was defined as the proportion of days in the measurement period covered by prescription claims for the same medication or another (LABA, LAMA, LAMA+ICS, theophylline or SABA) in its therapeutic category. From our results showed the adjusted HRs of the risk of dementia in COPD patients among PDC < 80% and PDC ≥ 80% with different factors before matching. Compared with the PDC < 80%, the COPD patients with a PDC ≥ 80% had a risk of dementia with adjusted HR 1.07 but there were no statistically significant differences (95% CI: 0.75-1.53) and Figure1. To the best of our knowledge, we evaluate association between PDC of COPD medication and the risk of dementia. The major finding is that a high PDC of COPD medication may not decrease risk of dementia.

Saowapha Srisai is family physician at Songkhla hospital in Thailand. She enjoys interacting with patients and provide recommendation about how they could take care of themselves. Her passion is in trying to improve prevention and treatment in chronic disease’s patients as well as training medical students to apply their knowledge efficiently. Her main area of expertise include administration MDI and prevention by lowering risk factors.

Chronic Obstructive Pulmonary Disease (COPD) is a common lung disease characterized by airflow limitation. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline suggests a short-acting inhaled bronchodilators and anticholinergic inhaled agents as a first line COPD treatment. In spite of its popularity, many COPD patients use inhalers incorrectly. This is a cross-sectional study. The sample includes patients diagnosed with COPD who visit Muangsongkhla hospital (N=92) during 1-31 July 2016. The inhaler technique was directly observed during their visits. Data were analyzed by Program R version 2.13.0. 92 patients diagnosed with COPD were enrolled in this study. Prevalence of the incorrect administration of MDI dispensing a short-acting bronchodilator by COPD patients in primary care setting was 72.8%. Breath-holding for at least 10 seconds after inhalation was found to be the most critical step that was mistaken. Education was found to be significantly associated with the incorrect administration of MDI dispensing a short-acting bronchodilator. Almost three quarters of COPD patients in primary care setting administer short-acting bronchodilator incorrectly. The most important factors associated with incorrect inhaler usage of the MDI are education and income. Therefore, healthcare provider team should carefully provide the instruction for the methods of using MDI administration to COPD patients and reinforce them periodically asking the patients to demonstrate how they administer MDI.