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Personalised COPD dispensing reports sent out
GPs have been asked to review their PBS dispensing patterns, as data suggests a gap between practice and clinical guidelines.
Spirometry has been described as ‘critical’ for the diagnosis of COPD.
GPs around the country have been sent personalised reports on PBS dispensing patterns for chronic obstructive pulmonary disease (COPD) treatments, as data suggests a gap between current practice and updated clinical guidelines.
The details, sent as part of the Practice Reflections series from the Australian Commission on Safety and Quality in Health Care (ACSQHC), include COPD-specific dispensing data from 2025, along with comparisons to patterns shown by other GPs in similar remoteness areas.
Associate Professor Liz Marles, former RACGP President and ACSQHC’s Clinical Director, noted the challenges in managing the disease.
‘It remains a leading cause of death in Australia and as GPs, we witness firsthand the impact COPD has on our patients,’ she told newsGP.
‘From this frontline position, we have a critical role to play in slowing the progression of COPD.’
She emphasises the report ‘is not an audit or assessment, but information for self-directed professional reflection’.
‘No one else has access to this individualised data, including the [ACSQHC],’ she said, adding that Continuing Professional Development hours can be claimed for time spent reviewing and reflecting on current practice.
The ACSQHC says the rationale behind the latest report is based around Atlas Focus data showing a 130% increase in triple therapy dispensing – Inhaled Corticosteroid (ICS) / Long-Acting Muscarinic Antagonist (LAMA)/ Long-Acting Beta2-Agonist (LABA) – between 2015–16 and 2022–23.
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, said triple therapy in its own right is not the issue.
‘It’s unindicated triple therapy that’s the problem, because it exposes patients to ICS-related harms without the exacerbation-reduction benefit that justifies taking on that risk,’ she said.
‘There is good evidence that there is increased risk of pneumonia in people with COPD taking ICS – the higher doses of ICS have the higher risk and some molecules have higher risk than others.
‘There is increased risk of oral candidiasis, dysphonia, and easy bruising with ICS exposure and there are also additional risks, such as fractures, osteoporosis, cataracts and diabetes that accumulate with duration of unnecessary exposure, especially high-dose ICS.’
She said an accurate and confirmed diagnosis with spirometry is critical.
A new COPD Clinical Care Standard was launched by the ACSQHC in October 2024.
An ACSQHC spokesperson said an important element of the Clinical Care Standard is the COPD-X stepwise approach to pharmacotherapy, with the Atlas Focus figures ‘raising questions about how well current practice nationally aligns with the stepwise approach’.
‘The Practice Refections: COPD medicines report aims to support GPs in this area by enabling them to explore individual data patterns and look for improvements to align more closely with best practice COPD management guidelines, while considering any barriers that may exist,’ they told newsGP.
A sample of the letter sent to GPs, which was reviewed by the RACGP, is on the ACSQHC website.
The ACSQHC’s first Practice Reflections report, published last November, also emphasised the importance of spirometry for diagnosing COPD.
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ACSQHC Australian Commission on Safety and Quality in Health Care COPD spirometry
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