Frequency of β-Blocker Use Following Exacerbations of COPD in Patients with Compelling Indication for Use

To assess the current use of β-blockers in patients with compelling indications for use, following the acute exacerbation of chronic obstructive pulmonary disease (COPD).

We performed a multicenter retrospective observational study using data from all of the patients admitted to five institutions for an acute exacerbation of COPD. Patients were included if they were admitted for an acute exacerbation of COPD and had a compelling indication for the use of a β-blocker, defined as previous myocardial infarction or heart failure with left ventricular ejection fraction ≤40%.

There were 396 patients meeting the criteria for inclusion in the study. The population was predominantly white men with myocardial infarction as the most prevalent compelling indication. On admission, 267 (67.4%) patients were receiving β-blockers, which increased to 278 (70.2%) at discharge. There were 118 (29.8%) patients discharged without β-blockers. Of the predictors tested, none were significantly predictive of a patient not receiving β-blockers upon discharge; however, home and in-hospital β-blockers reduced the likelihood of being discharged without a β-blocker. Of the 129 patients not receiving β-blockers prehospitalization, 23 (17.8%) were discharged with a new prescription for a β-blocker.

Nearly one-third of patients with compelling indications for β-blockers were not prescribed the therapy at discharge.