Withdrawal of Inhaled Corticosteroids in Primary Care Patients With COPD

Exclusion Criteria

• •A spirometry test that has demonstrated airflow reversibility (i.e., post-bd FEV1 improvement of at least 12% and 200 ml compared to baseline and/or post-bd FEV1 improvement of 9% of the baseline FEV1 % predicted value) that preceded the initiation of ICS treatment;
• •Diagnosis of asthma in the medical record (ICPC code R96);
• •Allergic respiratory disease which has been confirmed by a positive skin prick test or specific immunoglobulin E (IgE) in serum as documented in the medical record, in combination with a documented history respiratory allergic symptoms;
• •Two or more exacerbations in the previous 12 months that were treated with oral corticosteroids, antibiotics, or both; and/or required a visit to an emergency care facility or hospital admission;
• •Use of oral corticosteroids on a regular basis (i.e., more than six weeks in the previous half year) for any reason;
• •Currently participating in another intervention study that interferes with the current study;
• •Has one or more serious other diseases that are likely to lead to study drop-out (e.g., diseases with limited life expectancy) or influence the study results; or
• •Pregnancy or women who are trying to conceive a child;
• •Unable to read or understand the Dutch language.