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. 2018 Jan 25;18(1):17.
doi: 10.1186/s12890-018-0573-0.

Exacerbations and healthcare resource utilization among COPD patients in a Swedish registry-based nation-wide study

Gunnar Johansson  1 , Vasili Mushnikov  2 , Tobias Bäckström  3 , Andreas Engström  3 , Javaria Mona Khalid  4 , Jennifer Wall  2 , Fabian Hoti  5
Affiliations

Exacerbations and healthcare resource utilization among COPD patients in a Swedish registry-based nation-wide study

Gunnar Johansson et al. BMC Pulm Med. .

Abstract

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are an important measure of disease severity in terms of impaired disease progression, increased recovery time, healthcare resource utilization, overall morbidity and mortality. We aimed to quantify exacerbation and healthcare resource utilization rates among COPD patients in Sweden with respect to baseline treatments, exacerbation history, and comorbidities.

Methods: Patients with a COPD or chronic bronchitis (CB) diagnosis in secondary care at age of ≥40 years on 1.7.2009 were identified and followed until 1.7.2010 or death. Severe exacerbations were defined as hospitalizations due to respiratory disease, and healthcare resource utilization was measured by all-cause hospitalizations and secondary care visits. Poisson regression was used adjusting for age, gender, time since COPD/CB diagnosis, and Charlson comorbidity index.

Results: In 88,548 patients (54% females, mean age 72 years), previous respiratory hospitalizations and current high use of COPD medication (double or triple therapy) predicted an 8.3-fold increase in severe exacerbation rates and 1.8-fold increase in healthcare resource utilization rates in the following year, compared to patients without combination treatment and/or history of severe exacerbations.

Conclusions: COPD/CB patients with history of severe exacerbations and high use of COPD medication experienced a significantly increased rate of severe exacerbations and healthcare resource utilization during the one-year follow-up.

Keywords: Burden of disease; COPD; Chronic bronchitis; Exacerbations; Healthcare resource utilization; Hospitalizations; Pharmacoepidemiology.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Swedish National Board of Health and Welfare (Socialstyrelsen 26.11.2013) and by the Ethics Committee in Stockholm (diary number 2013/1412-31/2). The social security numbers of identified patients were replaced with study identification numbers at the Swedish National Board of Health and Welfare prior to data processing. No informed consent was required for this study.

Consent for publication

Not applicable.

Competing interests

AE, and JMK are employed at Takeda A/S, the sponsor of this study. At time of study TB was employed at Takeda A/S, but presently is employed by GSK. VM, JW, and FH are employees of EPID Research. EPID Research is a contract research organization that performs commissioned pharmacoepidemiological studies and thus their employees have been and currently are working in collaboration with several pharmaceutical companies (including Takeda A/S); GJ has worked as a consultant on this study.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The distribution of the Charlson comorbidity index (CCI) stratified by number of all-cause hospitalizations during one year prior to baseline. The number of patients within each stratum is given in the bottom panel
Fig. 2
Fig. 2
The distribution of the Charlson comorbidity index (CCI) stratified by number of respiratory hospitalizations during one year prior to baseline. The number of patients within each stratum is given in the bottom panel
See this image and copyright information in PMC

References

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