Objectives The objectives of this study were to describe medication use, treatment patterns and adherence, as well as acute exacerbations of chronic obstructive pulmonary disease (AECOPD) among adults living with COPD. Methods A retrospective observational study using administrative data (linked by unique person-level personal health numbers) between 1 April 2007 and 31 March 2018 from Alberta, Canada was performed. Individuals aged ≥35 years who had been living with COPD ≥1 year on 1 April 2017 (index date) were identified. COPD-related medication use was determined on the index date (baseline), and medication use, treatment patterns, adherence and AECOPD were measured during the 1-year postindex observation period; descriptive statistics were applied. Results Among the total cohort (n=192 814), 59% were not using a COPD-related medication at baseline; among those using medication, the most common (>10%) classes were short acting bronchodilators only (29%), dual inhaled corticosteroids/long acting beta2 agonists (ICS/LABA, 27%), combined ICSs/LABA/long acting muscarinic antagonist (ICS/LABA/LAMA, 21%) and LAMA monotherapy (12%). During the observation period, those with baseline COPD medication use had low adherence (42% were adherent (medication possession ratio ≥0.80) to their baseline medication class) and AECOPD were common (13%–40%); 66% of those with ≥1 dispensation for an additional medication class had a step-up in therapy that was concordant with guideline recommendations. Conclusions In this population-based study, the majority of individuals identified as living with COPD were not taking any COPD-related medication, while in those who were taking medication, adherence was low, deficits in alignment to guideline-recommended therapy were observed and many had AECOPD. Strategies for earlier identification of undertreatment, consideration of guideline-based knowledge transfer strategies and mechanisms to improve long-term medication adherence may improve outcomes. Data may be obtained from a third party and are not publicly available. The datasets analysed during the current study are not publicly available because the data custodians, Alberta Health Services and Alberta Health do not allow users of the data to publish the data. Please contact the corresponding author for requests related to the data used in this study.

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患有慢性阻塞性肺病的加拿大人的药物使用情况：一项队列研究

目的 本研究的目的是描述慢性阻塞性肺疾病 (COPD) 成人患者的药物使用、治疗模式和依从性，以及慢性阻塞性肺疾病 (AECOPD) 的急性加重。方法 使用 2007 年 4 月 1 日至 2018 年 3 月 31 日加拿大艾伯塔省的行政数据（通过独特的个人健康号码链接）进行回顾性观察研究。确定了 2017 年 4 月 1 日（索引日期）年龄≥35 岁、患有 COPD ≥1 年的个体。在索引日期（基线）确定与 COPD 相关的药物使用情况，并在索引后 1 年观察期内测量药物使用情况、治疗模式、依从性和 AECOPD；应用描述性统计。结果 在整个队列中 (n=192 814)，59% 的人在基线时未使用 COPD 相关药物；在使用药物的患者中，最常见（>10%）的类别是仅短效支气管扩张剂（29%）、双吸入皮质类固醇/长效β2激动剂（ICS/LABA，27%）、联合ICS/LABA/长效毒蕈碱拮抗剂（ICS/LABA/LAMA，21%）和 LAMA 单一疗法（12%）。观察期间，基线 COPD 药物使用的患者依从性较低（42% 遵守基线药物类别（药物持有率≥0.80）），AECOPD 很常见（13%–40%）；在额外药物类别 ≥1 次配药的患者中，66% 的治疗升级符合指南建议。结论 在这项基于人群的研究中，大多数被确定患有慢性阻塞性肺病的人没有服用任何与慢性阻塞性肺病相关的药物，而在服用药物的人中，依从性较低，观察到与指南推荐的治疗存在缺陷，并且许多患有 AECOPD。及早识别治疗不足的策略、考虑基于指南的知识转移策略和提高长期药物依从性的机制可能会改善结果。数据可能从第三方获得，并且不公开。当前研究期间分析的数据集尚未公开，因为数据保管机构、艾伯塔省卫生服务局和艾伯塔省卫生局不允许数据用户发布数据。如需与本研究中使用的数据相关的请求，请联系通讯作者。