Journal Article

S39 Polypharmacy in patients with non-cystic fibrosis bronchiectasis: the BRONCHUK observational study

Watson, R, Shield, T, Duckers, J, Upadhyay, H, Carroll, M, Walker, P, Haworth, C, Hurst, J, Mawson, P, Steer, J, Chalmers, J, Bradley, J, McNally, R, Kelly, M, Loebinger, M R, Elborn, S, Sullivan, A, Hill, A, Brown, J, De Soyza A, Gatheral, T

2025

Overview

IntroductionBRONCHUK is a multicentre, prospective, observational cohort study enrolling adults with radiologically confirmed bronchiectasis across secondary centres in the UK. The objectives of the study are to develop a multicentre bronchiectasis registry incorporating baseline data collection with annual follow-up data for at least 5 years and to describe treatment patterns across the UK.Polypharmacy is defined as the concurrent use of ≥5 medications and has been rarely documented in literature for bronchiectasis patients. Polypharmacy has been associated with increased risk of adverse drug reactions and increased treatment burden. The current BTS guidelines have not detailed the impact of polypharmacy in bronchiectasis patients.MethodsAdult patients with a clinical diagnosis of bronchiectasis supported by CT Thorax were recruited in the study across multiple centres in the UK. Patient data collected at baseline included demographics, aetiology testing, comorbidities, lung function, radiology, treatments, microbiology and quality of life. Both respiratory and non-respiratory medications were included in the database but are not exhaustive.Results1626 patients were included in the analysis [1000 females (61.5%); 626 males (38.5%)] with a mean age of 64.4±13.4 years. 611 (37.6%) patients had documented asthma, 255 (15.7%) COPD and 58 (3.6%) ABPA.The mean BSI score was 7.3±3.5.376 patients (23.1%) had ≥5 respiratory-related medications prescribed. 643 patients (39.5%) had documented polypharmacy (including non-respiratory medications).321 (36%) patients without co-existing asthma/COPD were prescribed ICS.A weak positive relationship was established between age and number of medications prescribed (r=0.126;p<0.001). Higher rates of polypharmacy were seen in male cohort (45.5% as compared to 37.1% in female cohort) (χ2 =11.360;p<0.001).A logistic regression analysis showed that with each 1-point increase in BSI score the odds of polypharmacy increased by 20% (OR = 1.197, p <.001).Abstract S39 Figure 1[Image Omitted. See PDF.]ConclusionPolypharmacy is a growing concern due to risks of cumulative harm. Since this database didn’t collect all medications prescribed to patients, the current polypharmacy rates are underreported. Polypharmacy was associated with gender and disease severity. LABA and ICS were the most frequently prescribed medications. As new therapies and precision medicine emerge in bronchiectasis minimising polypharmacy should be considered.

• Publisher: BMJ Publishing Group LTD
• Subject: Asthma / Cohort analysis / Medical treatment / Polypharmacy