LAUSR

research found that the addi-tion of low-dose oral theophylline to ICS did not reduce exacerbations among adults with COPD at high risk of exacerbation. 12 This therapeutic option has now been removed from COPD clinical guidelines and physicians should no longer prescribe low-dose oral theophylline. Pragmatic trials can also take the form of cluster randomized trials where groups of patients rather than indi-viduals are randomized. This innovative study design is practical, financially viable and enables patient factors such as adherence to be assessed. 13 are randomized, the of finding, patient follow-up and management of primary can be potentially addressed.