Abstract:
BACKGROUND:COPD is a prevalent disease that generates high use of resources. The objective of this study was to quantify the economic consequences of non-adherence to GOLD guidelines for the management of COPD patients. METHOD:An economic model was generated to compare different scenarios of observed vs. expected costs of COPD treatment. A pooled analysis of data derived from a systematic review of studies describing treatment of COPD in Spain was combined with drug costs (using different assumptions) to obtain the observed cost of COPD treatment. An expected cost was obtained with the minimum and maximum treatment intensity derived from the GOLD recommendations. RESULTS:A total of 8 studies were identified, comprising 6339 patients. Average medication cost of COPD patients was estimated as being between euro 1218 and euro 1314 per patient per year, higher than the ideal expected average cost (between euro 1007 and euro 1021 per patient/year). Thus, implementation of guidelines would result in a mean reduction of euro 198-euro 293 per patient/year. Sensitivity analysis showed that about 13% of patients had higher treatment costs than the maximum expected cost. This proportion is much higher in moderately/severely affected patients than in mildly affected patients (28.0% and 11.1%, respectively). CONCLUSIONS:Treatment of COPD allows for the identification of areas of inefficiency. An improvement in the adherence to the GOLD guidelines would imply potential savings of medication costs of about 20% of the observed costs.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Miravitlles M,Brosa M,Velasco M,Crespo C,Gobartt E,Diaz S,González-Rojas Ndoi
10.1016/j.rmed.2008.11.019subject
Has Abstractpub_date
2009-05-01 00:00:00pages
714-21issue
5eissn
0954-6111issn
1532-3064pii
S0954-6111(08)00421-6journal_volume
103pub_type
杂志文章abstract::Obstructive sleep apnoea syndrome (OSAS) has acute and chronic effects on the cardiovascular system. Both right and left sides of the heart are affected. Electrocardiographic pattern was studied in 190 OSAS patients. One or more of the following were found: persistent deep S in lateral chest leads V5, V6 (79%), left a...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(98)90027-0
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:It is documented that omalizumab treatment reduces the cell surface expression of immunoglobulin E high-affinity receptor (FcɛRI) on several cell types. This has not been investigated in patients with uncontrolled severe persistent allergic asthma. METHODS:In a double-blind, randomized, placebo-controlled s...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2010.07.011
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To examine medication adherence and persistence among COPD patients during their last year of life. DATA SOURCE:National VA databases were used to identify patients who had COPD and died between 1999 and 2003. STUDY DESIGN:We examined use of inhaled corticosteroids (ICS), long acting beta(2) agonists (LABA)...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2008.11.004
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Anti-CADM-140 antibody (anti-CADM-140), also referred to as anti-melanoma differentiation-associated gene 5 (MDA5) antibody, is a myositis-specific antibody identified in the sera of patients with clinically amyopathic dermatomyositis (C-ADM) and is associated with a worse prognosis in dermatomyositis-associ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2011.05.006
更新日期:2011-09-01 00:00:00
abstract::The objective of this study was to describe asthma exacerbation self-management in children and adolescents. We used a cross-sectional study population enrolled in the International Study of Asthma and Allergies in Childhood (ISAAC) in Bordeaux. Subjects answered an additional questionnaire on utilization of health se...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1053/rmed.2000.0888
更新日期:2000-11-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) affects 6% of the general population and is the fourth-leading cause of death in the United States with severe and very severe disease accounting for 15% and 3% of physician diagnoses of COPD. Guidelines make few recommendations regarding providing the provision of care for...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rmed.2007.02.011
更新日期:2007-08-01 00:00:00
abstract::Assessment of asthma severity is important for disease management. Analysis of symptoms past and present, and previous and actual lung function measurements (including variability) is the usual method of evaluation and classification of asthma disease severity and activity. However, symptoms and lung function alterati...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/s0954-6111(97)90003-2
更新日期:1997-11-01 00:00:00
abstract:INRODUCTION:The mechanistic target of rapamycin inhibitors (mTORi) sirolimus and everolimus stabilize lung function in patients with pulmonary lymphangioleiomyomatosis (LAM) but do not induce remission. Pre-clinical studies suggest that simvastatin in combination with sirolimus induces LAM cell death. The objective of ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2020.105898
更新日期:2020-03-01 00:00:00
abstract::Induced sputum and bronchoalveolar lavage (BAL) are widely used for retrieving cells and soluble materials for studies of airway inflammation. Centrifuged cell samples are suitable for immunochemical identification of cellular products. The aim was to determine the optimal fixation procedure to detect intracellular an...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1053/rmed.2002.1373
更新日期:2002-11-01 00:00:00
abstract::Bird fancier's lung, the most common form of extrinsic allergic alveolitis in Britain, can be a difficult diagnostic problem. The symptoms are non-specific, often insidious in onset and frequently misdiagnosed as influenza or a viral or bacterial pneumonia. Frequently there is a delay in eliciting the history of expos...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(06)80230-1
更新日期:1992-03-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is now the most common indication for single lung transplantation. In long-term follow-up, obliterative bronchiolitis is a major problem. The aim of the present study was to perform a long-term follow-up of the pulmonary function and to examine the effect of development of ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(96)90148-1
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Patients with severe or very severe chronic obstructive pulmonary disease (COPD) frequently suffer repeated exacerbations generating high health care utilization costs. Combined corticosteroid and bronchodilator treatment using a single inhaler might - via improved compliance - reduce exacerbation rates. OB...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2012.12.020
更新日期:2013-04-01 00:00:00
abstract::Synovial sarcoma most commonly occurs in the peri-articular regions of the extremities. The present report describes a rare case of primary biphasic synovial sarcoma of the pleura in an 18-year-old female. The diagnosis was made on the basis of light microscopy, immunohistochemistry, electron microscopy and the charac...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(97)90093-7
更新日期:1997-10-01 00:00:00
abstract::Report of an incidental chest X-ray finding of a large vessel dilation at the root of the ascending aorta in a 65-year-old female patient while pre-operative routine diagnostic. Due to prior allergic reaction to iodine contrast agent, non-invasive imaging was performed with magnetic resonance imaging (MRI), where the ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.10.023
更新日期:2008-05-01 00:00:00
abstract::In developing countries, many sputum-negative suspects of pulmonary tuberculosis (PTB) are given antituberculous medication just because tuberculosis (TB) could not be excluded in them. Many studies have shown that BCG test is nearly 100% sensitive, except in those with severe malnutrition, steroid therapy and other c...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1053/rmed.2003.1478
更新日期:2003-05-01 00:00:00
abstract::We have proposed a clinical treatment guideline for the management of acute, severe asthma and chronic obstructive pulmonarydisease (COPD) using the principles of evidence-based medicine. The content is based upon practical clinical issues in need of consensus. A previous study has shown that this particular area is i...
journal_title:Respiratory medicine
pub_type: 指南,杂志文章,实务指引
doi:10.1053/rmed.2002.1332
更新日期:2002-09-01 00:00:00
abstract:INTRODUCTION:Primary ciliary dyskinesia (PCD) is a rare genetically heterogeneous disorder of motile cilia, which leads to recurrent and chronic airway infections. Detailed information about infection causing pathogens is scarce. With this study, we aimed to determine the prevalence and susceptibility of the most commo...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2019.08.009
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The current literature suggests a relationship between obstructive sleep apnea (OSA) severity and hematocrit. However, the degree that OSA contributes to clinically significant erythrocytosis is uncertain. The aim of this study is to evaluate this association in a large study sample controlling for multiple ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2017.07.003
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Sleep disorders have a high prevalence among patients with idiopathic pulmonary fibrosis (IPF). The prevalence of restless legs syndrome (RLS) is not known in these patients, neither is its clinical impact as a comorbidity. We investigated the association of RLS with IPF and characterized the clinical feature...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2020.105982
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Small fiber neuropathy commonly affects patients with sarcoidosis and is often refractory to standard immunosuppressive therapies used for systemic disease. The clinical features of sarcoidosis-associated small fiber neuropathy (SSFN) and its response to medical therapy have not been described in a large popu...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2017.03.011
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Since extraintestinal sites of inflammation have been demonstrated in patients with Crohn's disease (CD) and ulcerative colitis (UC), both entities are regarded as systemic disorders. There are only scarce data on the prevalence of inflammatory bowel disease (IBD)-associated lung involvement in children. OB...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2012.03.005
更新日期:2012-07-01 00:00:00
abstract::Although in the clinic the presence of mucus in the airways is known to be an important factor influencing the sound of coughing in pathological conditions, this observation has not been established experimentally. We have substituted mucus in the airways of anaesthetized cats with 0.5 ml of natural undiluted egg albu...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(05)80313-0
更新日期:1993-01-01 00:00:00
abstract::Abnormal heart rate recovery (HRR) after exercise, a marker of cardiac autonomic dysfunction, is associated with poor prognosis in various populations. As chronic obstructive pulmonary disease (COPD) is associated with cardiac autonomic dysfunction, we tested the hypothesis that patients with COPD have a lower HRR tha...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2004.11.012
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:The Korea Centers for Disease Control & Prevention has implemented a review process for the approval of new drugs used to treat patients with multidrug-resistant tuberculosis (MDR-TB) since September 2016. Therefore, this study aimed to evaluate the efficacy and safety of these new drugs bedaquiline (Bdq) and d...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2020.105956
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Having a child with a chronic disease may cause anxiety and depression and impair the sleep quality in the mothers. The aim of this study was to evaluate sleep quality in asthmatic children and their mothers as well as the status of anxiety-depression in the mothers. METHODS:Study group consisted of 75 asth...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.07.025
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To assess whether tumor necrosis factor (TNF) antagonism can attenuate eosinophilic airway inflammation in patients with mild-to-moderate allergic asthma. DESIGN:Randomized, double-blind, placebo-controlled trial. SETTING:National Institutes of Health (NIH) Clinical Center. PATIENTS:Twenty-six patients wit...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2005.02.031
更新日期:2005-09-01 00:00:00
abstract::The objective of this study was to evaluate the effect of lateral body position on gas exchange in patients with unilateral pleural effusion, with special reference to the influence of effusion volume. Thirty consecutive patients with unilateral pleural effusion, without evidence of parenchymal pulmonary involvement, ...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0954-6111(95)90091-8
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVES:To assess the utility of capsaicin test in the differential diagnosis of non-productive causes of chronic cough and to examine the effects of treatment on this reflex. PARTICIPANTS:86 healthy volunteers and 101 patients with chronic cough: asthma (n: 54) gastroesophageal reflux (n: 35) and post-nasal drip s...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章
doi:10.1053/rmed.2002.1460
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Omalizumab is a recombinant humanized monoclonal anti-IgE antibody approved in adults and adolescents with moderate-to-severe persistent allergic asthma inadequately controlled with inhaled corticosteroids (ICS). EXCELS is an ongoing prospective observational cohort study of approximately 5000 omalizumab-tre...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.rmed.2012.09.008
更新日期:2013-01-01 00:00:00
abstract::From about 1190 to the present day opposing views have been expressed about the effects of coughing in patients with asthma. Some accounts have stated that it brought relief and others that it exacerbated asthma, whereas others thought that it could have both effects. In the present investigation, 187 patients with a ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(06)80246-5
更新日期:1991-01-01 00:00:00