Two cohorts will be produced. First, a CPRD cohort, using linked primary care, medication, Hospital Episode Statistics, and socio-economic data, according to the
following inclusion criteria:
I. Diagnosis of COPD before index date (time period will be defined in the SAP)
2. Aged 240 at index date.
3. Alive, and registered with a GP, at index date.
4. Not registered with a GP in the Greater Manchester area.
Second, a Salford cohort will be constructed using the Salford Integrated Record (SIR), according to the inclusion criteria:
1. Diagnosis of COPI) before index date.
2. Aged 240 at index date.
3. Alive, and registered with a GP, at index date.
Restricted cohorts will then be constructed in both the Salford and CPRD populations, based on the inclusion/exclusion criteria and study period for the SLS:
1. Patients with documented GP diagnosis of COPD, and currently receiving maintenance therapy
2. Male or female subjects aged 240 years of age at index date
3. Patients who have a history of treatment with systemic/oral corticosteroids, antibiotics (in association with GP contact) and/or hospitalisation for at least one
COPI) exacerbation in the 3 years prior to index date.
4. Current COPD Therapy
All patients currently receiving either:
- inhaled corticosteroid (ICS) alone or in combination with a long acting bronchodilator (this could be a fixed dose combination or an ICS/LABA provided in two separate inhalers, or ICS and LAMA),
- or long-acting bronchodilator therapy alone (e.g. tiotropium or salmeterol, or the use of two bronchodilators i.e. LABA/LAMA),
- or "triple therapy" i.e. ICS/LABA plus a Long Acting Muscarinic Antagonist (LAMA)
Finally, the third data source, the SLS, will be used as-is.
Exclusion Criteria
Subjects meeting any of the following criteria must not be included in the restricted cohorts:
1. Patients with any life threatening condition or uncontrolled/clinically significant disease (code list to be specified in the Study A
