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Observational Study
. 2024 Jul 31;24(1):370.
doi: 10.1186/s12890-024-03186-4.

Clinical and economic burden of acute exacerbations of idiopathic pulmonary fibrosis: a prospective observational study in Spain (OASIS study)

Ana Villar Gómez  1 , M J Rodríguez-Nieto  2 , E Cano-Jiménez  3 , A Romero Ortiz  4 , M Morros  5 , A Ramon  6 , S Armengol  6
Affiliations
Observational Study

Clinical and economic burden of acute exacerbations of idiopathic pulmonary fibrosis: a prospective observational study in Spain (OASIS study)

Ana Villar Gómez et al. BMC Pulm Med. .

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is a fatal progressive lung disease entailing significant impairment in health-related quality of life (HRQoL) and high socioeconomic burden. The course of IPF includes episodes of acute exacerbations (AE-IPF) leading to poor outcomes. This study aimed to compare management, costs and HRQoL of patients with AE-IPF to patients without AE-IPF during one year in Spain.

Materials and methods: In a 12-month, prospective, observational, multicenter study of IPF patients, healthcare resource use was recorded and costs related to AE-IPF were estimated and compared between patients with and without AE-IPF. HRQoL was measured with the St. George's Respiratory Questionnaire (SGRQ), EuroQoL 5 dimensions 5 levels questionnaire (EQ-5D-5L), EQ-5D visual analogue scale (EQ-VAS) and the Barthel Index.

Results: 204 IPF patients were included: 22 (10.8%) experienced ≥ 1 acute exacerbation, and 182 (89.2%) did not. Patients with exacerbations required more primary care visits, nursing home visits, emergency visits, hospital admissions, pharmacological treatments and transport use (p < 0.05 for all comparisons). Likewise, patients with exacerbations showed higher annual direct health AE-IPF-related costs. In particular, specialized visits, emergency visits, days of hospitalization, tests, palliative care, transport in ambulance and economic aid (p < 0.05 for all comparisons). Exploratory results showed that patients with AE-IPF reported a non-significant but substantial decline of HRQoL compared with patients without AE-IPF, although causality can be inferred.

Conclusion: We observed significantly higher resource use and cost consumption and lower HRQoL among patients suffering exacerbations during the study. Thus, preventing or avoiding AE-IPF is key in IPF management.

Keywords: Acute exacerbation; Economic impact; IPF; Idiopathic pulmonary fibrosis; Resource use.

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Conflict of interest statement

AV has received consulting fees from Boehringer Ingelheim and Roche; fees for talks/lectures from Boehringer Ingelheim, GlaxoSmithKline and Roche; and funding for conferences attendances and courses from Boehringer Ingelheim, Chiesi, Novartis and Roche. MJRN has received funding for research (data monitoring boards), consulting fees and honoraria for presentations/lectures and for being an advisor from Boehringer Ingelheim and Roche. ECJ has received funding for research and consulting fees for presentations/lectures and for being an advisor from Boehringer Ingelheim, Galapagos and Roche. ADRO has received funding for research and consulting fees for presentations/lectures and for being an advisor from Boehringer Ingelheim and Roche. MM is a full-time employee of Adelphi Targis. AR and SA are full-time employees of Boehringer Ingelheim España.

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