The integrated primary care information experience in COPD in the Netherlands

Using an intent-to-treat analysis approach, a retrospective study (n=1,096) compared the survival rates of treatment with salmeterol, fluticasone, fluticasone plus salmeterol, and a reference group utilising data from the Integrated Primary Care Information database in the Netherlands, a longitudinal observational database consisting of computer-based patient records of >150 general practitioners in the Netherlands. Treatment with salmeterol plus fluticasone (adjusted risk ratio (RRadj) 0.37, 95% confidence interval (CI) 0.21-0.67) or fluticasone alone (RRadj 0.34, 95% CI 0.18-0.66) resulted in significant survival advantage compared with the reference group alone. This result did not change in a series of sensitivity analyses that aimed to study the effect of quality care, disease misclassification, or exposure misclassification.