Factors affecting the choice of therapeutic regimens in asthma and chronic obstructive pulmonary disease patients and patient adherence to the therapies prescribed

Introduction
Chronic obstructive pulmonary disease (COPD) and asthma are the most common chronic respiratory diseases worldwide. At the moment, there is no information about the preferences of Polish specialists in the treatment of asthma and COPD or factors influencing the choice of particular treatment regimens.

Aim
To determine the treatment options most commonly used by experienced pulmonologists and allergists for asthma and COPD and to identify the factors affecting the choice of a particular therapy.

Material and methods
The survey included 224 doctors (pulmonologists and allergists) across Poland and was concerned with patients diagnosed with asthma (n = 4358) and COPD (n = 3062).

Results
In the case of asthma, the most common therapy applied was inhaled glucocorticosteroids and long-acting β₂-agonists. According to 27.2% of doctors, a combination therapy was used in 70–80% of patients while 23.7% declared that the proportion of patients receiving such a treatment exceeded 80%. In the case of COPD, anticholinergics were most frequently prescribed when inhaled glucocorticosteroids and long-acting β₂-agonists had proved insufficient. According to 21% of specialists, the percentage of patients thus treated was 41–50%, while 19% declared the use of this treatment in 71–80% of patients.

Conclusions
The most common treatments for asthma and COPD in Poland are inhaled glucocorticosteroids and long-acting β₂-agonists. The main factors influencing treatment decisions are the current GINA and GOLD recommendations as well as patients’ age, comorbidities, and price of treatment.