{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T06:35:45Z","timestamp":1793169345057,"version":"4.5.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Technology"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The Global Initiative for Chronic Obstructive Lung Disease (GOLD) report recommends initial bronchodilator therapy over inhaled corticosteroids (ICS) for most patients. However, real-world prescribing often diverges. Management is further complicated in hospitalized patients with suspected but unconfirmed chronic obstructive pulmonary disease (COPD), where providers must decide on therapy initiation and outpatient follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe inhaler prescribing in suspected but unconfirmed COPD upon hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was an institutional review board\u2013approved retrospective cohort study of patients of ages 40 years or older with a smoking history of at least 10-pack years, but without a prior COPD diagnosis, who presented with a suspected COPD exacerbation or acute respiratory failure secondary to suspected COPD. The primary outcome was inhaler prescribing at discharge. Secondary outcomes included confirmed COPD diagnosis, guideline concordance, hospital readmission for a COPD exacerbation, and ICS-related adverse events within 180 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 51 patients included in the study, 29 (56.9%) were prescribed new inhalers, with 15 (29.4%) prescribed ICS-containing regimens. Following discharge, 15 patients (29.4%) completed pulmonary function testing, with 8 (15.7%) receiving a COPD diagnosis. Guideline concordance could not be assessed due to absent documentation. Eight patients (15.7%) were readmitted with a COPD exacerbation, and 13 ICS-related adverse events were documented. Limitations include the sample size and retrospective study design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study found a high frequency of initial ICS prescribing for suspected but unconfirmed COPD, as well as limited follow-up and diagnostic reassessment. These findings highlight the need for system-level interventions to optimize discharge prescribing and ensure timely follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/87551225261454868","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:52:16Z","timestamp":1782795136000},"page":"275-281","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Inhaler Prescribing Trends in Hospitalized Patients With Suspected but Unconfirmed Chronic Obstructive Pulmonary Disease"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-2521","authenticated-orcid":false,"given":"Alexandra E.","family":"Mihm","sequence":"first","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA"},{"name":"Wingate University School of Pharmacy, Wingate, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria J.","family":"Wingler","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA"},{"name":"Wingate University School of Pharmacy, Wingate, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison P.","family":"Owen","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA"},{"name":"Wingate University School of Pharmacy, Wingate, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6407-4191","authenticated-orcid":false,"given":"Erica R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA"},{"name":"Wingate University School of Pharmacy, Wingate, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00470-6"},{"key":"e_1_3_4_3_2","unstructured":"Global strategy for prevention diagnosis and management of chronic obstructive pulmonary disease. Published 2023. Accessed August 4 2023. https:\/\/goldcopd.org\/wp-content\/uploads\/2023\/03\/GOLD-2023-ver-1.3-17Feb2023_WMV.pdf"},{"key":"e_1_3_4_4_2","unstructured":"Global strategy for prevention diagnosis and management of chronic obstructive pulmonary disease. Published 2022. Accessed August 4 2023. https:\/\/goldcopd.org\/wp-content\/uploads\/2021\/12\/GOLD-REPORT-2022-v1.1-22Nov2021_WMV.pdf"},{"key":"e_1_3_4_5_2","unstructured":"Chronic Obstructive Pulmonary Disease (COPD). Published July 15 2025. 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