NPJ Primary Care Respiratory Medicine最新文献

{"title":"Reflections on 10 years of research capacity building.","authors":"Gwyneth A Davies, Hilary Pinnock, Kathryn Ferris, Aziz Sheikh","doi":"10.1038/s41533-026-00484-8","DOIUrl":"10.1038/s41533-026-00484-8","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"36 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical factors associated with severely reduced health status in patients with COPD and comorbid depression/anxiety: The Swedish PRAXIS study.","authors":"Therese Öfverholm, Mikael Hasselgren, Karin Lisspers, Anna Nager, Gabriella Eliason, Maaike Giezeman, Christer Janson, Marta A Kisiel, Scott Montgomery, Björn Ställberg, Josefin Sundh, Hanna Sandelowsky","doi":"10.1038/s41533-026-00522-5","DOIUrl":"10.1038/s41533-026-00522-5","url":null,"abstract":"<p><p>Patients with COPD and comorbid depression/anxiety are at risk of reduced health status. This study aimed to assess health status in COPD patients with depression/anxiety, the occurrence of severely reduced health status in this group, and to investigate associations between severely reduced health status and patient-related clinical factors. This cross-sectional study included 2245 randomly selected COPD patients from primary care and hospital outpatient clinics in Sweden. The COPD Assessment Test (CAT) and the Clinical COPD Questionnaire (CCQ) were used to assess health status. Severely reduced health status was defined as CAT ≥ 20 or CCQ ≥ 2. The 524 patients (23.3%) who reported depression/anxiety had higher mean CAT scores (18.3 vs. 15.2, p < 0.001) and CCQ scores (2.37 vs. 1.83, p < 0.001) than patients without depression/anxiety. In this group, 48% had CAT ≥ 20 and 57% had CCQ ≥ 2. In patients with depression/anxiety, factors associated with CAT ≥ 20 were: onset of COPD symptoms before 60 years of age (OR = 2.62 [95% CI 1.37-5.04]), frequent symptoms of depression in the previous three months (2.59 [1.55-4.30]), one or more COPD exacerbations in the previous six months (2.37 [1.41-4.00]) and physical inactivity (1.89 [1.11-3.22]). Apart from physical inactivity, factors associated with CCQ ≥ 2 were the same as for CAT ≥ 20. Approximately half of the COPD patients with comorbid depression/anxiety reported severely reduced health status. Exacerbations, frequent depressive symptoms and physical inactivity were factors associated with severely reduced health status, and constitute important treatable and preventable traits of COPD.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"36 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educating the patient, controlling the disease: a point prevalence evaluation of structured pharmaceutical asthma care in real world settings.","authors":"Maja Simonoska Crcarevska, Zorica Naumovska, Beti Zafirova Ivanovska, Biljana Bozhinovska, Joana Andonoska, Sashka Janevska, Siân Williams, Jaime Correia-de-Sousa, Katarina Stavriкј","doi":"10.1038/s41533-026-00524-3","DOIUrl":"10.1038/s41533-026-00524-3","url":null,"abstract":"<p><p>Asthma control remains suboptimal worldwide, often due to modifiable factors such as incorrect inhaler technique and reliever overuse. Community pharmacists (CPs) are well-positioned to address these gaps through structured patient education. A point prevalence evaluation was conducted in 1247 patients across 127 community pharmacies (11.1% of all pharmacies) in North Macedonia (Dec 2023-Sep 2024). Asthma control was assessed using the Asthma Control Test (ACT), while Asthma Slide Rule (ASR) was used to evaluate short-acting beta-agonists (SABAs) use. Inhaler technique was assessed using device-specific checklists. CPs provided comprehensive care, including adherence support, lifestyle counselling, and monitoring. Poor inhaler technique strongly predicted poor asthma control (ACT: OR = 5.98; ASR: OR = 6.43). Among 127 patients followed, correct technique improved from 71.7% at baseline to 88.8% at the second visit, and among patients who attended all three visits, accuracy increased from ∼63% at the first visit to∼89% at the second and 98.2% at the third (56 patients). By the third visit, the association between technique and control diminished, reflecting the success of comprehensive pharmaceutical care. These results highlight the critical, multifaceted role of CPs in improving asthma outcomes and support the integration of CP-led comprehensive pharmaceutical care for asthma into national management strategies.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives of asthma treatment and belief barriers to implementing new guidelines: a qualitative analysis of an online forum.","authors":"Zoe Moon, Hannah Truscott, Grainne d' Ancona, Anna De Simoni, Louise Fleming, Mark L Levy, Aziz Sheikh, Robert Horne","doi":"10.1038/s41533-026-00483-9","DOIUrl":"10.1038/s41533-026-00483-9","url":null,"abstract":"<p><p>For the last 40 years, the first line of asthma treatment has been short-acting beta2 agonists (SABA) used as symptom relief alongside daily inhaled corticosteroids (ICS) as preventers. New guidelines recommend replacing SABA relievers with ICS-based relievers (ICS-formoterol) because of clear risks from excess and sole use of SABA. This study aimed to explore patient perceptions of SABA, ICS and ICS-formoterol, with a focus on identifying barriers to adherence to new recommended treatments. A qualitative study was carried out investigating UK asthma online community forum posts using keyword searches between July 2021 and March 2025. Inductive thematic analysis was used to analyze the data, informed by the Necessity Concerns Framework. 326 posts were identified across 206 adults with asthma. Thematic analysis highlighted that many people remained attached to their SABA and viewed it as a key element of their treatment. They appeared unconvinced by warnings around SABA over-use and were dissatisfied with the quality of advice from health care professionals (HCPs). In contrast, they raised a range of concerns about ICS and ICS-formoterol, and had reservations about replacing SABA with these treatments. A common objection to replacing SABA was that ICS-formoterol does not provide the same symptom relief. Results highlight a perceived lack of individualized care from HCPs and insufficient explanation and justification of treatment changes. This analysis highlights several potential barriers to adherence to recommended asthma treatment. Strategies to support the implementation of asthma treatment guidelines should include addressing patients' treatment beliefs and educating clinicians to better communicate treatment changes.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative risk of pneumonia and acute exacerbation between P-CAB and PPI use in patients with COPD and GERD.","authors":"SooBeen Park, Seoung Ju Park, Hyuk Soon Choi, Hankil Lee, Jae Hyun Kim, Ha-Lim Jeon","doi":"10.1038/s41533-026-00523-4","DOIUrl":"10.1038/s41533-026-00523-4","url":null,"abstract":"<p><p>Potassium-competitive acid blockers (P-CABs) are newer gastric acid suppressants used to treat gastroesophageal reflux disease (GERD), but evidence regarding their respiratory safety compared with proton pump inhibitors (PPIs) in patients with chronic obstructive pulmonary disease (COPD) remains limited. We conducted a target trial emulation study using the Korean National Health Insurance database. Patients aged ≥40 years with COPD who initiated P-CAB or PPI for GERD between 2019 and 2022 were included. Follow-up continued from treatment initiation until the earliest occurrence of the outcome, treatment discontinuation, switching to another drug class, death, or the end of the study period. The outcome was the occurrence of pneumonia or moderate-to-severe COPD exacerbations. Propensity score matching (1:3) was applied, and hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Among the 560,987 eligible patients, 4671 P-CAB users and 14,013 PPI users were included after matching. P-CAB was not significantly associated with the risk of respiratory events compared with PPI, but a trend toward lower risks for pneumonia (aHR, 0.76; 95% CI, 0.54-1.07) and severe exacerbations (aHR, 0.60; 95% CI, 0.32-1.14) was observed. In patients with a Charlson Comorbidity Index ≤1, the risk of severe exacerbations was significantly lower (aHR, 0.31; 95% CI, 0.11-0.88). P-CABs showed lower risks of pneumonia and severe exacerbations compared with PPIs, although the differences were not statistically significant. Further long-term studies across diverse patient subgroups are warranted.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, awareness, treatment and control of chronic obstructive pulmonary disease (COPD) among community-dwelling adults aged 40 years and older in regional China.","authors":"Jian Kang, Huiqing Xu, Qing Ye, Zhiyong Wang, Caihong Hu, Yunting Xu, Guofeng Ao, Xiaojing Deng, Yeping Bian, Jian Xu, Fei Xu","doi":"10.1038/s41533-026-00508-3","DOIUrl":"10.1038/s41533-026-00508-3","url":null,"abstract":"<p><p>This study aimed to investigate the prevalence, awareness, treatment and control rates of chronic obstructive pulmonary disease (COPD) and their influencing factors among adults in regional China. In 2023, 6403 community-dwelling residents aged 40 years and older were randomly chosen from Nanjing municipality of China. COPD was determined as self-reported physician-diagnosed patients or post-bronchodilator FEV₁/FVC < 0.70, and without other lung function impaired diseases. Multivariate logistic regression models were introduced to identify influencing factors for each rate. Totally, 5605 participants were analyzed. The spirometry-based COPD prevalence, awareness, treatment and control rates were 15.4%, 4.4%, 2.4% and 56.8%, separately, while the corresponding age- and sex-standardized rates were 15.5%, 4.6%, 2.4% and 56.5%, respectively. Age, marital status, education, physical activity and body weight status significantly correlated with COPD prevalence. Among COPD patients, these with higher educational level, chronic respiratory symptoms, or family history, and former smokers were more likely to be aware of COPD. Those smoking formerly, aged 60-79 years, with chronic respiratory symptoms, family history of COPD, higher educational level, or physical inactivity were more likely to receive treatment. Additionally, patients living in urban areas tended to have the disease under control. The prevalence of COPD among adults aged 40 years and older was high, but awareness, treatment and control rates remained limited in regional China. For the purpose to reduce COPD burden, it shall be a priority for policy-makers to initiate/provide effective and accessible education and lung function screening programs of COPD for adults in China.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health outcomes in older adults with COPD: the role of clinical and psychosocial factors in post-acute geriatric rehabilitation.","authors":"Veerle H E W Brouwer, Henk Jan Schuijt, Jisca W F A Vrancken, Johanna M A Visser-Meily, Wilco P Achterberg, Eléonore F van Dam van Isselt","doi":"10.1038/s41533-026-00517-2","DOIUrl":"10.1038/s41533-026-00517-2","url":null,"abstract":"<p><p>Older adults with COPD hospitalised for an acute exacerbation often face frailty, comorbidity, and psychosocial challenges. This study aimed to identify clinical and psychosocial predictors of changes in disease-specific health status over three months in older adults with COPD following hospitalisation for an exacerbation and indicated for geriatric COPD rehabilitation (the GR_COPD programme). Prospective cohort study with three-month follow-up. Two Dutch hospitals; 78 patients participated in the GR_COPD programme and 80 patients received usual care. Disease-specific health status was assessed with the Clinical COPD Questionnaire (CCQ) at baseline and 3 months. Regression analyses were used to identify predictors of CCQ change, with a sensitivity analysis using the minimal clinically important difference (MCID). Baseline CCQ was the most consistent predictor of change, with patients reporting worse initial health status showing greater improvement. Participation in the GR_COPD programme and comorbidity burden were independently associated with achieving clinically meaningful improvement, whereas exacerbation history and psychosocial factors were not. Baseline health status was the most consistent predictor of short-term change in disease-specific health status following hospitalisation for COPD exacerbation. Participation in the GR_COPD programme was associated with clinically meaningful improvement in frail older adults. Taken together, these findings underscore the value of systematic baseline clinical assessment to better understand short-term trajectories in frail older adults with COPD.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of different home-based pulmonary rehabilitation models in patients with COPD: a systematic review and network meta-analysis.","authors":"Ye-Yiyi Xing, Lin-Yi Wu, Shu-Yang Gong, Fu-Ming Ye, Hong-Guo Rong, Hai Hui","doi":"10.1038/s41533-026-00513-6","DOIUrl":"10.1038/s41533-026-00513-6","url":null,"abstract":"&lt;p&gt;&lt;p&gt;To compare the efficacy and safety of four home-based pulmonary rehabilitation models-traditional home-based pulmonary rehabilitation, telerehabilitation, hybrid pulmonary rehabilitation, and self-management pulmonary rehabilitation-in patients with COPD. We sought to generate comparative evidence against usual care and center-based pulmonary rehabilitation to guide model selection in clinical practice. We systematically searched PubMed, Embase, CINAHL, Scopus, and the Cochrane Library from inception to May 1, 2025 for randomized controlled trials involving adults with COPD. A frequentist random-effects network meta-analysis was conducted using Stata 15.0 to synthesize direct and indirect evidence across prespecified outcomes: the six-minute walk test (6MWT), St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnea scale, Chronic Respiratory Disease Questionnaire (CRQ) domains, Hospital Anxiety and Depression Scale (HADS), and adverse events (AEs). Global and local consistency were assessed and rankings were summarized using the surface under the cumulative ranking curve (SUCRA). The risk of bias was evaluated with RoB 2.0 tool, and the protocol was registered on PROSPERO (CRD420251038495). A total of 39 RCTs involving 3610 patients were included. For exercise capacity, telerehabilitation, traditional home-based pulmonary rehabilitation, and hybrid pulmonary rehabilitation significantly improved 6MWT compared with usual care, and no statistically significant differences were observed between any home-based model and center-based pulmonary rehabilitation for the 6MWT. For health-related quality of life, telerehabilitation, traditional home-based pulmonary rehabilitation, and hybrid pulmonary rehabilitation significantly reduced SGRQ total scores versus usual care. For health status, telerehabilitation significantly improved CAT scores compared with usual care [MD = -2.49, 95% CI (-4.76, -0.22)]. For dyspnea-related outcomes, self-management pulmonary rehabilitation, hybrid pulmonary rehabilitation and traditional home-based pulmonary rehabilitation improved the mMRC dyspnea scale versus usual care. Telerehabilitation also improved HADS-Anxiety scores versus usual care [MD = -1.40, 95% CI (-2.79, -0.01)] and depression scores versus both self-management pulmonary rehabilitation [MD = -1.31, 95% CI (-2.53, -0.09)] and usual care[MD = -1.34, 95% CI (-2.51, -0.18)]. Ranking probabilities suggested that traditional home-based pulmonary rehabilitation had the lowest likelihood of adverse events among home-based models. Home-based pulmonary rehabilitation models yield clinically meaningful improvements in COPD and may provide exercise-capacity benefits comparable to center-based pulmonary rehabilitation. As effects and rankings vary across outcomes, no single model is optimal for all patients. Model selection should consider patient needs, digital access, and available resources.&lt;/p","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female smokers' perspectives on tobacco use and smoking cessation: a qualitative study guided by health belief model.","authors":"Ying Ying Choo, Aileen Chelsea Ai'En Lim, Cia Sin Lee, Ngiap Chuan Tan","doi":"10.1038/s41533-026-00518-1","DOIUrl":"10.1038/s41533-026-00518-1","url":null,"abstract":"<p><p>Tobacco use among women remains a significant public health concern. Although overall smoking prevalence has declined locally, the reduction among female smokers has been comparatively slower. Existing cessation strategies may not sufficiently address the unique factors shaping women's smoking behaviour. This study explored female smokers' perspectives on tobacco use and the factors influencing their cessation. A qualitative study was conducted between February 2024 to February 2025 in a primary care setting in Singapore. Semi-structured in-depth interviews (IDIs) were carried out with 14 female smokers aged 21-59 years, recruited through purposive sampling. All interviews were conducted in English, guided by the Health Belief Model (HBM), audio-recorded, transcribed verbatim, and analysed thematically. Five key themes were identified: (1) Perceived susceptibility to smoking and its harm, including concerns about physical appearance, smoking-related symptoms, and health risks to themselves and their children. (2) Perceived severity of health and social risks, such as cardiorespiratory disease, premature mortality, and strong social and cultural stigma associated with female smoking. (3) Perceived benefits of quitting, including improved health, strengthened family relationships, and financial savings. (4) Perceived barriers to smoking cessation, particularly psychosocial and emotional barriers. (5) Cues to action, including public health messaging, encouragement from family and peers, and life-stage transitions that prompted contemplation and motivation to quit. This study highlights the complex interplay of psychological, social, and environmental influences on female smoking behaviour. Interventions should adopt a multifaceted, gender-responsive approach that addresses psychological barriers, enhances self-efficacy, and incorporates sociocultural support to strengthen cessation outcomes.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled corticosteroid overuse and deprescribing eligibility in COPD (iCODEC Study): a nationwide cross-sectional analysis in China.","authors":"Changcheng Shi, Xuedi Ma, Weizhong Jin, Xinyi Li, Junbo Xia, Nengming Lin, Lihong Liu","doi":"10.1038/s41533-026-00519-0","DOIUrl":"10.1038/s41533-026-00519-0","url":null,"abstract":"<p><p>Inhaled corticosteroid (ICS) overuse is common in chronic obstructive pulmonary disease (COPD) and associated with substantial adverse effects. Deprescribing has emerged as a strategy to optimize therapy, yet large-scale evidence on the prevalence and associated factors of eligibility for ICS deprescribing is limited. This nationwide cross-sectional study analyzed data from the Cough and Wheeze Pharmaceutical Care Clinics database between January 2021 and September 2024. Patients aged ≥40 years with physician-diagnosed COPD receiving long-acting inhaled therapies were included. We examined treatment patterns, estimated ICS use, and assessed eligibility for deprescribing using European Respiratory Society (ERS), American Thoracic Society (ATS), and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2026 criteria, applied respectively to any ICS-containing regimens, triple therapy, and ICS/long-acting beta-agonist (LABA) combinations. Factors associated with ICS deprescribing eligibility were identified using multivariable logistic regression, with sensitivity analyses on complete-case data. Of 33,243 patients, 24,886 (74.9%) received ICS-containing regimens, mainly triple therapy and ICS/LABA. Among them, 79.5% met ERS criteria for deprescribing. In the triple therapy subgroup (n = 12,388), 68.9% met ATS criteria, while 74.0% of patients on ICS/LABA combinations (n = 12,340) met GOLD criteria. Eligibility was positively associated with male sex, older age, higher regional economic level, lack of health insurance, and care in secondary hospitals, whereas higher comorbidity burden was negatively associated. Sensitivity analyses yielded consistent results. These findings highlight that ICS overuse is common among COPD patients in China, with most being eligible for deprescribing. Implementing targeted strategies that address the identified associated factors could support deprescribing and enhance treatment optimization.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}