Abstract:
Objective:To determine the clinical and economic consequences of inhaled corticosteroid doses and particle size in patients on triple-inhalation therapy for COPD. Methods:Patients aged ≥40 years who initiated treatment with multi-inhaler triple-inhaled therapy between 1 January 2015 and 31 March were included and followed for 1 year. Patients were grouped according to inhaled corticosteroid (ICS) dose (low/medium/high) and particle size device (extrafine/non-extrafine particles). Outcome variables were moderate and severe exacerbations, pneumonia and healthcare resource use (HCRU) costs. A multivariate analysis was performed for model correction (p<0.05). Results:A total of 2185 patients (mean age 72.3 years, 82.9% male) were analysed. Of these, 849 (38.9%) patients received low-dose ICS, 612 medium-dose ICS (28.0%) and 724 (33.1%) high-dose ICS. Exacerbations occurred more frequently with increasing IC dose (low: 26.4%, medium: 28.7% and high: 30.4%; p=0.047), as did the proportion of pneumonia (3.4%, 4.2% and 6.9%, respectively (p=0.041)). The annual mean cost/unit was € 2383 for low dose, € 2401 for medium dose and € 2625 for high dose (p=0.024). Four hundred and sixty-two (31.6%) patients used an extrafine particle device and 999 (68.4%) a non-extrafine particle device: the proportion of exacerbations was 24.0% vs 30.4% (p=0.012), and the annual mean cost/unit was € 2090 vs € 2513, respectively (p<0.001). The number of exacerbations was directly correlated with FEV1 (β= -0.157), age (β=0.071), Charlson index (β=0.050) and device type (extrafine: β=0.049) (p<0.02). Conclusion:In patients with COPD receiving multi-inhaler triple therapy, higher ICS doses were not associated with a further reduction in exacerbations, whereas we found an increased risk of pneumonia. The use of inhaler devices delivering extrafine ICS particle was associated with a lower rate of exacerbations, resulting in lower overall HCRU costs.
journal_name
Int J Chron Obstruct Pulmon Disauthors
Sicras-Mainar A,de Abajo FJ,Izquierdo-Alonso JLdoi
10.2147/COPD.S281333subject
Has Abstractpub_date
2020-12-09 00:00:00pages
3291-3302eissn
1176-9106issn
1178-2005pii
281333journal_volume
15pub_type
杂志文章abstract:BACKGROUND:COPD patients are often prescribed multiple medications for their respiratory disease and comorbidities. This can lead to complex medication regimens resulting in poor adherence, medication errors, and drug-drug interactions. The relationship between clinical outcomes and medication burden beyond medication ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S136256
更新日期:2017-10-06 00:00:00
abstract::Currently, there is no cure for chronic obstructive pulmonary disease (COPD). The limited efficacy of current therapies for COPD indicates a pressing need to develop new treatments to prevent the progression of the disease, which consumes a significant amount of health care resources and is an important cause of morta...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/COPD.S32604
更新日期:2014-02-24 00:00:00
abstract:Introduction:Biomass smoke exposure (BSE) is a recognized cause of COPD particularly in rural areas. However, little research has been focused on BSE in suburban areas. Objective:The aim of this study was to determine the prevalence of COPD, respiratory symptoms (RS) and BSE in women living in a suburban area of Mexic...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S156409
更新日期:2018-05-25 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S214737
更新日期:2019-09-05 00:00:00
abstract:BACKGROUND:A year-long pan-Canadian quality improvement collaborative (QIC) led by the Canadian Foundation for Healthcare Improvement (CFHI) supported the spread of the successful Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ to 19 teams in the 10 Canadian provinces. We describe QIC results, addressing two...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S140043
更新日期:2017-07-26 00:00:00
abstract:Background:Chronic obstructive pulmonary disease (COPD) is prevalent and poses a heavy burden worldwide. However, patients know little about COPD, and primary health care providers have poor therapy capability in China. Enjoying Breathing Program aims to establish a new comprehensive COPD patient management system, inc...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S258479
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVE:β-Blockers are safe and improve survival in patients with both congestive heart failure (CHF) and COPD. However, the superiority of different types of β-blockers is still unclear among patients with CHF and COPD. The association between β-blockers and CHF exacerbation as well as COPD exacerbation remains uncl...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S141694
更新日期:2017-08-26 00:00:00
abstract:Objectives:To describe the trends in pharmacologic treatment for patients newly diagnosed with chronic obstructive pulmonary disease (COPD) in Alberta, Canada. Methods:We linked Alberta health databases to identify patients aged ≥35 years with incident COPD between April 2010 and March 2017. Incident cases were define...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S214191
更新日期:2019-09-26 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S20067
更新日期:2011-01-01 00:00:00
abstract::Background: Qualitative research provides real-life information on patients' condition and facilitates informed design of future clinical studies. Objective: We used Online Communities as a qualitative research tool to evaluate the effect of cough and mucus on COPD patients. Methods: Two 2-week Online Communities were...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S202580
更新日期:2019-06-24 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S84337
更新日期:2015-07-15 00:00:00
abstract:Purpose:Primary care COPD guidelines indicate that COPD patients with asthma characteristics should be treated as having asthma. This study aims to describe the prevalence of asthma characteristics in patients with a pulmonologist-confirmed working diagnosis of COPD or ACO. Patients and Methods:This retrospective cros...
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pub_type: 杂志文章
doi:10.2147/COPD.S247819
更新日期:2020-07-06 00:00:00
abstract:OBJECTIVES:To explore the mediating role of protein interleukin-6 (IL-6) on the relationship between forced expiratory volume in 1 second (FEV1) and 6-minute walk distance (6MWD) and, further, to determine whether status variables (such as age, sex, and body mass index [BMI]) operate as moderators of this mediation rel...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S57845
更新日期:2014-10-07 00:00:00
abstract::Abstract: Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/copd.s1822
更新日期:2008-01-01 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S110504
更新日期:2016-09-06 00:00:00
abstract::[This corrects the article on p. 3485 in vol. 13, PMID: 30498338.]. ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,已发布勘误
doi:10.2147/COPD.S194746
更新日期:2018-12-05 00:00:00
abstract:BACKGROUND:There is conflicting information regarding the effects of selective and nonselective beta-blocker treatment in patients with COPD. PARTICIPANTS AND METHODS:This nested case-control study used the Taiwan National Health Insurance Research Database. We included COPD patients who used inhalation steroid and be...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S145913
更新日期:2017-10-11 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare. AIM:Comparisons of symptoms, impact of symptoms on function and health between patients w...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S62563
更新日期:2014-07-18 00:00:00
abstract:BACKGROUND:Nowadays, there is increasing awareness about the frequent chronic comorbidities in patients with chronic obstructive pulmonary disease (COPD) but little information is available to quantify the burden of illness that these conditions cause in this population. We aimed to identify and describe a population s...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:Background:The risk of dying of lung cancer is up to eightfold higher in patients with COPD than in age- and gender-matched controls. The aim of this study was to investigate the factors associated with lung cancer in a large cohort of COPD patients from primary care centers. Methods:To analyze whether age, gender, so...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S162484
更新日期:2018-06-06 00:00:00
abstract:OBJECTIVE:Comorbidities are characteristic of COPD. However, little is known about the secondary manifestations of COPD in the gastrointestinal tract. Therefore, we aimed to explore the long-term effects of gastrectomy in patients with spirometry-defined COPD or those at risk of COPD. PARTICIPANTS:Subjects included 87...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S87135
更新日期:2015-10-29 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S111724
更新日期:2016-09-14 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究
doi:10.2147/COPD.S145910
更新日期:2017-11-13 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,随机对照试验
doi:10.2147/COPD.S145440
更新日期:2018-02-16 00:00:00
abstract:Purpose:Autophagy plays essential roles in the development of COPD. We aim to identify and validate the potential autophagy-related genes of COPD through bioinformatics analysis and experiment validation. Methods:The mRNA expression profile dataset GSE38974 was obtained from GEO database. The potential differentially ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S288428
更新日期:2021-01-12 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S80439
更新日期:2015-05-04 00:00:00
abstract::Etiological evidence demonstrates that there is a significant association between cigarette smoking and chronic airway inflammatory disease. Abnormal expression of placental growth factor (PlGF) has been reported in COPD, and its downstream signaling molecules have been reported to contribute to the pathogenesis of ai...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S120849
更新日期:2016-12-02 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) often have multiple underlying comorbidities, which may lead to increased health care resource utilization (HCRU) and costs. OBJECTIVE:To describe the comorbidity profiles of COPD patients and examine the associations between the presence of comorbi...
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pub_type: 杂志文章
doi:10.2147/COPD.S112256
更新日期:2017-02-23 00:00:00
abstract:Rationale:Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are caused by a variety of different etiologic agents. Our aim was to phenotype COPD exacerbations using imaging (chest X-ray [CXR] and computed tomography [CT]) and to determine the possible role of the blood tests (C-reactive protein [CRP...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S152484
更新日期:2018-01-08 00:00:00
abstract:INTRODUCTION:Pulmonary emphysema causes several electrocardiogram changes, and one of the most common and well known is on the frontal P-wave axis. P-axis verticalization (P-axis > 60°) serves as a quasidiagnostic indicator of emphysema. The correlation of P-axis verticalization with the radiological severity of emphys...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S45127
更新日期:2013-01-01 00:00:00