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Multicenter Study
. 2017 Feb 21:12:677-689.
doi: 10.2147/COPD.S123896. eCollection 2017.

COPD symptom burden: impact on health care resource utilization, and work and activity impairment

Bo Ding  1 , Mark Small  2 , Gina Bergström  3 , Ulf Holmgren  3
Affiliations
Multicenter Study

COPD symptom burden: impact on health care resource utilization, and work and activity impairment

Bo Ding et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) can greatly impact the quality of life by limiting patients' activities. However, data on impact of symptomatic burden on the health care resource utilization (HCRU) and employment in COPD are lacking. We examined the association between COPD Assessment Test (CAT) score and direct/indirect costs associated with HCRU and work productivity.

Methods: Data from >2,100 patients with COPD consulting for routine care were derived from respiratory disease-specific programs in Europe, the USA and China. Questionnaires, including CAT and Work Productivity and Activity Impairment (WPAI), were used to collect the past and current disease status data and HCRU characteristics from physicians (general practitioners/specialists) and patients. A regression approach was used to quantify the association of CAT with HCRU and WPAI variables. CAT score was modeled as a continuous independent variable (range: 0-40).

Results: Ninety percent of patients with COPD had a CAT score ≥10. Short-acting therapy and maintenance bronchodilator monotherapy, respectively, were currently prescribed to patients with CAT scores of 10-19 (5.8% and 27.6%), 20-29 (5.1% and 13.1%) and 30-40 (2.8% and 6.6%). Prescribing of maintenance bronchodilator dual therapy was low across the CAT score groups (0-9, 7.8%; 10-19, 6.4%; 20-29, 5.9%; 30-40, 4.4%), whereas maintenance triple combination therapy was prescribed more commonly in patients with higher CAT scores (0-9, 16.1%; 10-19, 23.2%; 20-29, 25.9%; 30-40, 35.5%). Increasing CAT scores were significantly associated with a higher frequency of primary care physician visits (P<0.001), pulmonologist visits (P=0.007), exacerbations requiring hospitalization (P<0.001) and WPAI scores (P<0.001).

Conclusion: Most patients with COPD presented with high symptom levels, despite being treated for COPD. Increasing symptom burden was associated with increasing HCRU and had a detrimental impact on work productivity.

Keywords: COPD; health care resource utilization; routine care; symptom; work and activity impairment.

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Conflict of interest statement

Disclosure UH, GB and BD are employees of AstraZeneca. MS is an employee of Adelphi Real World. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) CAT scores (mean, SD) and (B) CAT score domains by region, % patients. Abbreviations: 5EU, France, Germany, Italy, Spain and the UK; CAT, COPD Assessment Test; COPD, chronic obstructive pulmonary disease; SD, standard deviation.
See this image and copyright information in PMC

References

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