Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2015

Open Access 01-12-2015 | Study protocol

The Prospective Non-Interventional DACCORD Study in the National COPD Registry in Germany: design and methods

Published in: BMC Pulmonary Medicine | Issue 1/2015

Login to get access

Abstract

Background

A variety of large randomized controlled trials (RCT’s) evaluating pharmacotherapy in chronic obstructive pulmonary disease (COPD) patients does exist. One of the drugs that has been tested is the new long-acting anticholinergic glycopyrronium bromide.

Methods

As the generalizability of results from RCT’s is questionable we designed a longitudinal, prospective non-interventional study (DACCORD) of two years duration plus two years extension with at least 6000 participants in approximately 500 primary and secondary care practices in Germany (within the new established COPD National Prospective Registry), to assess patient reported outcomes (PRO’s), lung function, adherence and drug safety. To circumvent the hurdle of inappropriate COPD diagnosis in a non-interventional trial, patients have to fulfill the inclusion criteria of the COPD disease management program (DMP) of the German statutory health insurances. Patient management should follow the German national COPD guidelines, which are based on Global Initiative for Chronic Obstructive Lung Disease 2007 (GOLD) report. Labels of prescribed drugs should also be taken into account. Patients received treatment as part of their standard care: at the discretion of the investigator patients were included in one of two arms. A: standard care with glycopyrronium containing regimen, and arm B: standard care without glycopyrronium.

Discussion

For 2016 we expect important results regarding longitudinal development of PRO’s including exacerbations, lung function, adherence and side effects. We also investigate applicability of the new GOLD staging system in usual care. Data on diagnostic and treatment modalities in current German primary and secondary care, as well as pharmaco-economic data will be generated.

Trial registration

Literature
1.
go back to reference Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, et al.: International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study.Lancet 2007, 370:741–750. 10.1016/S0140-6736(07)61377-4CrossRefPubMed Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, et al.: International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study.Lancet 2007, 370:741–750. 10.1016/S0140-6736(07)61377-4CrossRefPubMed
2.
go back to reference Pritzkuleit R, Beske F, Katalinic A: Erkrankungszahlen in der Pneumologie - eine Projektion bis 2060.Pneumologie 2010, 64:535–540. 10.1055/s-0030-1255637CrossRefPubMed Pritzkuleit R, Beske F, Katalinic A: Erkrankungszahlen in der Pneumologie - eine Projektion bis 2060.Pneumologie 2010, 64:535–540. 10.1055/s-0030-1255637CrossRefPubMed
3.
go back to reference Orie NG, Sluiter HJ, de Vries K, Tammeling GJ, Witkop J: The host factor in Bronchitis. In Bronchitis. Edited by: Orie NG, Sluiter HJ. The Netherlands: Royal Van Gorcum Assen; 1961:43–59. Orie NG, Sluiter HJ, de Vries K, Tammeling GJ, Witkop J: The host factor in Bronchitis. In Bronchitis. Edited by: Orie NG, Sluiter HJ. The Netherlands: Royal Van Gorcum Assen; 1961:43–59.
4.
go back to reference Filley GF, Dart GA, Mitchell RS: Emphysema and chronic bronchitis: clinical manifestations and their physiological significance.Aspen Emphysema Conf. Aspen, Co. USA 1968, 9:339–349. PMID 5722666 Filley GF, Dart GA, Mitchell RS: Emphysema and chronic bronchitis: clinical manifestations and their physiological significance.Aspen Emphysema Conf. Aspen, Co. USA 1968, 9:339–349. PMID 5722666
5.
go back to reference Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: NHLBI/WHO workshop report. Bethesda: National Heart, Lung and Blood Institute; 2001:1–100. NIH Publication No 2701 Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: NHLBI/WHO workshop report. Bethesda: National Heart, Lung and Blood Institute; 2001:1–100. NIH Publication No 2701
6.
go back to reference Fletcher C, Peto R, Tinker CM: The Natural History of Chronic Bronchitis and Emphysema. Oxford: Oxford University Press; 1976. Fletcher C, Peto R, Tinker CM: The Natural History of Chronic Bronchitis and Emphysema. Oxford: Oxford University Press; 1976.
7.
go back to reference Tashkin DP: Variations in FEV(1) decline over time in chronic obstructive pulmonary disease and its implications.Curr Opin Pulm Med 2013, 19:116–124. 10.1097/MCP.0b013e32835d8ea4CrossRefPubMed Tashkin DP: Variations in FEV(1) decline over time in chronic obstructive pulmonary disease and its implications.Curr Opin Pulm Med 2013, 19:116–124. 10.1097/MCP.0b013e32835d8ea4CrossRefPubMed
8.
go back to reference Akkermans RP, Berrevoets MA, Smeele IJ, Lucas AE, Thoonen BP, Grootens-Stekelenburg JG, et al.: Lung function decline in relation to diagnostic criteria for airflow obstruction in respiratory symptomatic subjects.BMC Pulm Med 2012, 12:12. 10.1186/1471-2466-12-12CrossRefPubMedPubMedCentral Akkermans RP, Berrevoets MA, Smeele IJ, Lucas AE, Thoonen BP, Grootens-Stekelenburg JG, et al.: Lung function decline in relation to diagnostic criteria for airflow obstruction in respiratory symptomatic subjects.BMC Pulm Med 2012, 12:12. 10.1186/1471-2466-12-12CrossRefPubMedPubMedCentral
9.
go back to reference Mohamed Hoesein FA, Zanen P, Boezen HM, Groen HJ, van Ginneken B, de Jong PA, et al.: Lung function decline in male heavy smokers relates to baseline airflow obstruction severity.Chest 2012, 142:1530–1538. 10.1378/chest.11-2837CrossRefPubMed Mohamed Hoesein FA, Zanen P, Boezen HM, Groen HJ, van Ginneken B, de Jong PA, et al.: Lung function decline in male heavy smokers relates to baseline airflow obstruction severity.Chest 2012, 142:1530–1538. 10.1378/chest.11-2837CrossRefPubMed
10.
go back to reference ZuWallack RL, Nici L: Modifying the course of chronic obstructive pulmonary disease: looking beyond the FEV1.COPD 2012, 9:637–648. 10.3109/15412555.2012.710668CrossRefPubMed ZuWallack RL, Nici L: Modifying the course of chronic obstructive pulmonary disease: looking beyond the FEV1.COPD 2012, 9:637–648. 10.3109/15412555.2012.710668CrossRefPubMed
11.
go back to reference Rabe K, Wedzicha JA, Wouters E: COPD and Comorbidity. Edited by: European Respiratory Monograph. Sheffield: European Respiratory Society; 2013:1–228. ISBN ISBN 978–1-84984–032–3CrossRef Rabe K, Wedzicha JA, Wouters E: COPD and Comorbidity. Edited by: European Respiratory Monograph. Sheffield: European Respiratory Society; 2013:1–228. ISBN ISBN 978–1-84984–032–3CrossRef
12.
go back to reference Han MK, Muellerova H, Curran-Everett D, Dransfield MT, Washko GR, Regan EA, Bowler RP, Beaty TH, Hokanson JE, Lynch DA, Jones PW, Anzueto A, Martinez FJ, Crapo JD, Silverman EK, Make BJ: GOLD 2011 disease severity classification in COPDGene: a prospective cohort study.Lancet Respir Med 2013,1(1):43–50. 10.1016/S2213-2600(12)70044-9CrossRefPubMed Han MK, Muellerova H, Curran-Everett D, Dransfield MT, Washko GR, Regan EA, Bowler RP, Beaty TH, Hokanson JE, Lynch DA, Jones PW, Anzueto A, Martinez FJ, Crapo JD, Silverman EK, Make BJ: GOLD 2011 disease severity classification in COPDGene: a prospective cohort study.Lancet Respir Med 2013,1(1):43–50. 10.1016/S2213-2600(12)70044-9CrossRefPubMed
13.
go back to reference Wedzicha JA: GOLD and ABCD? A good start, but now for the evidence?Lancet Respir Med 2013,1(1):4–5. 10.1016/S2213-2600(12)70045-0CrossRefPubMed Wedzicha JA: GOLD and ABCD? A good start, but now for the evidence?Lancet Respir Med 2013,1(1):4–5. 10.1016/S2213-2600(12)70045-0CrossRefPubMed
14.
go back to reference Hausen T: New GOLD Guidelines for Treatment of COPD [Neue GOLD-Leitlinie zur Therapie der COPD].Pneumologie 2012, 66:768.CrossRefPubMed Hausen T: New GOLD Guidelines for Treatment of COPD [Neue GOLD-Leitlinie zur Therapie der COPD].Pneumologie 2012, 66:768.CrossRefPubMed
15.
go back to reference Jones R, Price D, Chavannes N, van de Molen T, Thomas M, Tsiligianni I, Williams S: GOLD COPD categories are not fit for purpose in primary care.Lancet Respir Med 2013,1(1):e17.CrossRef Jones R, Price D, Chavannes N, van de Molen T, Thomas M, Tsiligianni I, Williams S: GOLD COPD categories are not fit for purpose in primary care.Lancet Respir Med 2013,1(1):e17.CrossRef
16.
go back to reference Han MK, Lange P, Anzueto A, Martinez FJ, Jones PW: GOLD COPD categories are not fit for purpose in primary care? Authors’ reply.Lancet Respir Med 2013,1(1):e17-e18.CrossRefPubMed Han MK, Lange P, Anzueto A, Martinez FJ, Jones PW: GOLD COPD categories are not fit for purpose in primary care? Authors’ reply.Lancet Respir Med 2013,1(1):e17-e18.CrossRefPubMed
17.
go back to reference Pisa G, Freytag S, Schandry R: Chronic Obstructive Pulmonary Disease (COPD) patients’ disease-related preferences: a study using conjoint analysis.Patient 2013, 6:93–101. 10.1007/s40271-013-0007-2CrossRefPubMed Pisa G, Freytag S, Schandry R: Chronic Obstructive Pulmonary Disease (COPD) patients’ disease-related preferences: a study using conjoint analysis.Patient 2013, 6:93–101. 10.1007/s40271-013-0007-2CrossRefPubMed
18.
go back to reference Cochrane A: Effectiveness and Efficiency: Random Reflection on Health Services. London: Nuffield Provincial Hospital Trusts; 1972. Cochrane A: Effectiveness and Efficiency: Random Reflection on Health Services. London: Nuffield Provincial Hospital Trusts; 1972.
19.
go back to reference Vestbo J, Anderson W, Coxson HO, Crim C, Dawber F, Edwards L, et al.: Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE).Eur Respir J 2008, 31:869–873. 10.1183/09031936.00111707CrossRefPubMed Vestbo J, Anderson W, Coxson HO, Crim C, Dawber F, Edwards L, et al.: Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE).Eur Respir J 2008, 31:869–873. 10.1183/09031936.00111707CrossRefPubMed
20.
go back to reference Witt C, Tresz A, Wegscheider K: Externer Validität auf der Spur.Dtsch Arztebl 2011,108(46):2468–2474. Witt C, Tresz A, Wegscheider K: Externer Validität auf der Spur.Dtsch Arztebl 2011,108(46):2468–2474.
21.
go back to reference Corrado A, Rossi A: How far is real life from COPD therapy guidelines? An Italian observational study.Respir Med 2012, 106:989–997. 10.1016/j.rmed.2012.03.008CrossRefPubMed Corrado A, Rossi A: How far is real life from COPD therapy guidelines? An Italian observational study.Respir Med 2012, 106:989–997. 10.1016/j.rmed.2012.03.008CrossRefPubMed
22.
go back to reference Bourbeau J, Tan WC, Benedetti A, Aaron SD, Chapman KR, Coxson HO, et al.: Canadian Cohort Obstructive Lung Disease (CanCOLD): fulfilling the need for longitudinal observational studies in COPD.COPD 2014, 11:125–32. 10.3109/15412555.2012.665520CrossRefPubMed Bourbeau J, Tan WC, Benedetti A, Aaron SD, Chapman KR, Coxson HO, et al.: Canadian Cohort Obstructive Lung Disease (CanCOLD): fulfilling the need for longitudinal observational studies in COPD.COPD 2014, 11:125–32. 10.3109/15412555.2012.665520CrossRefPubMed
23.
go back to reference Travers J, Marsh S, Caldwell B, Williams M, Aldington S, Weatherall M, et al.: External validity of randomized controlled trials in COPD.Respir Med 2007, 101:1313–1320. 10.1016/j.rmed.2006.10.011CrossRefPubMed Travers J, Marsh S, Caldwell B, Williams M, Aldington S, Weatherall M, et al.: External validity of randomized controlled trials in COPD.Respir Med 2007, 101:1313–1320. 10.1016/j.rmed.2006.10.011CrossRefPubMed
24.
go back to reference Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al.: Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med 2012, 186:155–161. 10.1164/rccm.201201-0034OCCrossRefPubMed Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al.: Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med 2012, 186:155–161. 10.1164/rccm.201201-0034OCCrossRefPubMed
25.
go back to reference Beasley R, Singh S, Loke YK, Enright P, Furberg CD: Call for worldwide withdrawal of tiotropium Respimat mist inhaler.BMJ 2012, 345:e7390. 10.1136/bmj.e7390CrossRefPubMed Beasley R, Singh S, Loke YK, Enright P, Furberg CD: Call for worldwide withdrawal of tiotropium Respimat mist inhaler.BMJ 2012, 345:e7390. 10.1136/bmj.e7390CrossRefPubMed
26.
go back to reference Jenkins CR, Beasley R: Tiotropium Respimat increases the risk of mortality.Thorax 2013, 68:5–7. 10.1136/thoraxjnl-2012-202482CrossRefPubMed Jenkins CR, Beasley R: Tiotropium Respimat increases the risk of mortality.Thorax 2013, 68:5–7. 10.1136/thoraxjnl-2012-202482CrossRefPubMed
27.
go back to reference Vestbo J, Anderson J, Brook RD, Calverley PM, Celli BR, Crim C, et al.: The study to understand mortality and morbidity in COPD (SUMMIT) study protocol.Eur Respir J 2013, 41:1017–1025. 10.1183/09031936.00087312CrossRefPubMed Vestbo J, Anderson J, Brook RD, Calverley PM, Celli BR, Crim C, et al.: The study to understand mortality and morbidity in COPD (SUMMIT) study protocol.Eur Respir J 2013, 41:1017–1025. 10.1183/09031936.00087312CrossRefPubMed
Metadata
Title
The Prospective Non-Interventional DACCORD Study in the National COPD Registry in Germany: design and methods
Publication date
01-12-2015
Published in
BMC Pulmonary Medicine / Issue 1/2015
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-15-2

Other articles of this Issue 1/2015

BMC Pulmonary Medicine 1/2015 Go to the issue