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. 2012 Dec;21(4):377-83.
doi: 10.4104/pcrj.2012.00069.

Prevalence of common chronic respiratory diseases in drug misusers: a cohort study

Frances Palmer  1 , Mariesha Jaffray, Mandy A Moffat, Catriona Matheson, David J McLernon, Alasdair Coutts, John Haughney
Affiliations

Prevalence of common chronic respiratory diseases in drug misusers: a cohort study

Frances Palmer et al. Prim Care Respir J. 2012 Dec.

Abstract

Background: A randomised controlled trial of substance misuse indicated that many patients who use methadone have respiratory symptoms and/or are prescribed respiratory medications. There is little research in this area.

Aims: To determine the prevalence of respiratory disease and prescriptions among drug misusers.

Methods: This historical cohort study of drug misusers and matched controls analysed routinely collected primary care data. The prevalence of common chronic respiratory diseases, class and number of respiratory medications were examined.

Results: The cohort of 18,570 patients (9,285 per group) was mostly male (64%, n=11,890) and aged 31-59 years (76%, n=14,060). After adjusting for age, gender, deprivation and smoking status, the results showed that more drug misusers than controls had a diagnosis of asthma or chronic obstructive pulmonary disease (17.1% vs. 10.9%; adjusted odds ratio (OR) 1.61, 95% confidence interval (CI) 1.46 to 1.77, and 2.4% vs. 0.8%; OR 1.86, 95% CI 1.42 to 2.44, respectively) and were prescribed more chronic respiratory medications: short-acting β(2)-agonists (16.4% vs. 7.9%; OR 2.00, 95% CI 1.80 to 2.22), long-acting β(2)-agonists (1% vs. 0.4%; OR 1.93, 95% CI 1.29 to 2.89), and inhaled corticosteroids (10.6% vs. 7.6%; OR 1.49, 95% CI 1.33 to 1.67). All differences were statistically significant (p<0.001).

Conclusions: Drug misusers have a significantly higher prevalence of respiratory diseases and respiratory prescriptions than matched controls. Further work is needed to determine the reasons for this.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in relation to this article.

Figures

Figure 1
Figure 1
Proportion (95% CI) of drug misusers and controls having (A) respiratory system disease by gender (p value for interaction = 0.001), (B) respiratory system disease by age group (p=0.003), (C) asthma by gender (p=0.001), (D) asthma by age group (p<0.001)
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Comment in

References

    1. National Institute for Health and Clinical Excellence (NICE). Drug Misuse; Opioid Detoxification. Guideline number 52. London: NICE, 2008.
    1. Department of Health. United Kingdom Drug Situation. 2010 Edition. UK Focus point on drugs. Annual report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 29 October 2010.
    1. Donnelley RR. The Road to Recovery: A New Approach to Tackling Scotland's Drug Problem. 29 May 2008 (updated 25 March 2011). Available from: http://www.scotland.gov.uk/Publications/2008/05/22161610/0.
    1. NHS. National Services Scotland. ISD Scotland Publications. Drug Misuse Statistics Scotland. 2010 (updated 20 April 2011). Available from: www.drugmisuse.isdscotland.org.
    1. Matheson C, Jaffray M, Bond CM, et al. A cluster randomised control trial of Enhanced Pharmacy Services (EPS) for methadone patients. CSO Final Report Reference CZH/4/421, 2010.

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