According to a survey of SPIROMICS study patients, over half of inhaler use by these patients does not follow GOLD recommendations.

Researchers assigned participants to the 2011 GOLD COPD categories A (n=383), B (n=665), C (n=75), or D (n=598). Participants were stratified into aligned with inhaler regimen to first- or second-line GOLD recommendations (n=888) or nonaligned with recommendations (n=833). The nonaligned group was further categorized into overuse (n=384) and underuse (n=449) groups.

Underuse of medications in patients with nonaligned regimens was primarily the result of a lack of long-acting inhaler use in the GOLD D category. In the overuse group, 95% of participants were treated with nonindicated ICS-containing therapies.