Deciphering patterns of respiratory medication use in Ireland to target interventions appropriately: a focus on COPD.

BACKGROUND: Ireland has the highest rates of overnight hospitalisations for COPD in the OECD, yet lacks estimates of the prevalence of this disease or its pharmacological management. We aimed to estimate the age and sex-specific prevalence of symptomatic COPD and to identify patterns of respiratory medication use to inform interventions to improve pharmacotherapy in this condition. METHODS: We used the national pharmacy claims database, with data on a publically insured cohort in 2016. We restricted to those aged ≥ 45 years with full eligibility for that year and examined the age and sex distribution of respiratory medications, and patterns of medication use in those suggestive of COPD. RESULTS: In this cohort, 23% filled at least one prescription for a respiratory medication; 14% of males and 16% of females received at least one dispensing of an ICS inhaler. The proportion dispensed a long-acting muscarinic receptor antagonist (LAMA) was considerably lower. Of those newly initiated on a LAMA, 24% did not receive another within 60 days of the last covered day. The prevalence of medication use suggestive of COPD was 15% in males and 16% in females. CONCLUSION: The prevalence of medication use consistent with the management of symptomatic COPD mirrors international prevalence estimates. Several patterns raise concern: high ICS use in older adults, under use of LAMA therapy and poor persistence of those newly initiated. We recommend the development of an intervention to assist in the implementation of new national prescribing guidelines for the management of COPD.

Production and characterization of a polyclonal antibody for Os(II) and Ru(II) polypyridyl complexes.

The characterization of a polyclonal antibody produced via immunization with an [Os(bpy)(2)dcbpy] hapten is described. Bpy is 2,2'-bipyridine and dcbpy is 2,2'-bipyridine-4,4'-dicarboxylic acid. The cross-reactivity of the antibody for the Ru(II) analogue of the hapten was also investigated. Large increases in the emission and luminescent lifetime of a series of Os and Ru complexes were observed on binding of the antibody. Association equilibrium constants were derived from luminescence titration data and were found to be 5.6 x 10(8) and 5.0 x 10(8)M(-1) for [Os(bpy)(2)dcbpy] and [Ru(bpy)(2)dcbpy], respectively. Spectroscopic changes were likely due to the exclusion of H(2)O from the complex/antibody binding cleft and blocking of vibrational relaxation pathways of the Os/Ru excited state. D(2)O/H(2)O experiments confirmed that the antibody protected approx. 82% of [Os(bpy)(2)dcbpy] and 80% of [Ru(bpy)(2)dcbpy] from excited state deactivation by the aqueous solvent.

Mediated amperometric immunosensing using single walled carbon nanotube forests.

A prototype amperometric immunosensor was evaluated based on the adsorption of antibodies onto perpendicularly oriented assemblies of single wall carbon nanotubes called SWNT forests. The forests were self-assembled from oxidatively shortened SWNTs onto Nafion/iron oxide coated pyrolytic graphite electrodes. The nanotube forests were characterized using atomic force microscopy and resonance Raman spectroscopy. Anti-biotin antibody strongly adsorbed to the SWNT forests. In the presence of a soluble mediator, the detection limit for horseradish peroxidase (HRP) labeled biotin was 2.5 pmol ml(-1) (2.5 nM). Unlabelled biotin was detected in a competitive approach with a detection limit of 16 nmol ml(-1) (16 microM) and a relative standard deviation of 12%. The immunosensor showed low non-specific adsorption of biotin-HRP (approx. 0.1%) when blocked with bovine serum albumin. This immunosensing approach using high surface area, patternable, conductive SWNT assemblies may eventually prove useful for nano-biosensing arrays.