Yes, I’m concerned that for some patients once they are on triple therapy inappropriately, they’ll be overtreated which can cause unnecessary side effects, waste and harm. It may also then be a challenge to step the patient down to the appropriate treatment. However, it’s advantageous to patients who do need it (where it’s prescribed appropriately), as it simplifies medicines management and may improve adherence if the patient only needs to inhale the treatment in a single device.
Higher value interventions should always be explored before even considering triple therapy e.g. smoking cessation, flu vaccination, and pulmonary rehabilitation.