International journal of chronic obstructive pulmonary disease
-
Int J Chron Obstruct Pulmon Dis · Jan 2019
Comparative StudyClinical burden of illness among patients with severe eosinophilic COPD.
Background: There are currently limited real-world data on the clinical burden of illness in patients with COPD who continue to exacerbate despite receiving triple therapy. The aim of this study was to compare the burden of COPD in patients with and without a phenotype characterized by a high blood eosinophil count and high risk of exacerbations while receiving triple therapy. Methods: This retrospective cohort study (GSK ID: 207323/PRJ2647) used UK Clinical Practice Research Datalink records linked with Hospital Episode Statistics. ⋯ For GP visits and non-AECOPD-related unscheduled hospitalizations, adjusted rate ratios (95% CI), in patients with the study phenotype versus those without, were 1.09 (1.05, 1.12) and 1.31 (1.18, 1.46), respectively. Conclusion: Patients with COPD and raised blood eosinophil counts who continue to exacerbate despite MITT represent a distinct subgroup who experience substantial clinical burden and account for high healthcare expenditure. There is a need for more effective management and therapeutic options for these patients.
-
Int J Chron Obstruct Pulmon Dis · Jan 2019
Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study.
Impairment of diaphragmatic function is one of the main pathophysiological mechanisms of chronic obstructive pulmonary disease (COPD) and is known to be related to acute exacerbation. Ultrasonography (US) allows for a simple, non-invasive assessment of diaphragm kinetics. The purpose of this study was to investigate the changes in diaphragmatic function during acute exacerbation of COPD, by US. ⋯ These data support the possibility that a defect in diaphragm thickening is related to acute exacerbation of COPD.
-
Int J Chron Obstruct Pulmon Dis · Jan 2019
Survival associated with chronic obstructive pulmonary disease among SEER-Medicare beneficiaries with non-small-cell lung cancer.
Objective: We investigated the impact of preexisting COPD and its subtypes, chronic bronchitis and emphysema, on overall survival among Medicare enrollees diagnosed with non-small-cell lung cancer (NSCLC). Methods: Using SEER-Medicare data, we included patients ≥66 years of age diagnosed with NSCLC at any disease stage between 2006 and 2010 and continuously enrolled in Medicare Parts A and B in the 12 months prior to diagnosis. Preexisting COPD in patients with NSCLC were identified using ICD-9 codes. ⋯ In Cox proportional hazard model, COPD patients exhibited 11% increase in risk of death than non-COPD patients (HR: 1.11, 95%CI: 1.09-1.13). Conclusion: NSCLC patients with preexisting COPD had shorter survival with marked differences in early stages of lung cancer. Chronic bronchitis demonstrated a greater association with time to death than emphysema.
-
Int J Chron Obstruct Pulmon Dis · Jan 2019
Observational StudyEconomic impact of delaying initiation with multiple-inhaler maintenance triple therapy in Spanish patients with chronic obstructive pulmonary disease.
Guidelines recommend the use of triple therapy with an inhaled corticosteroid (ICS), a long-acting β2 agonist (LABA) and a long-acting muscarinic antagonist (LAMA) to reduce the risk of future exacerbations in symptomatic COPD patients with a history of exacerbations. This study aimed to estimate COPD-related healthcare resource use and costs, and subsequent exacerbation rates, for patients initiating multiple-inhaler triple therapy (MITT) early (≤30 days) versus late (31-180 days) following an exacerbation, in a real-world clinical setting. ⋯ Initiating MITT early (≤30 days after an exacerbation) may reduce health care costs and exacerbation rate compared with late MITT initiation.
-
Int J Chron Obstruct Pulmon Dis · Jan 2019
Identification of relevant variables and construction of a multidimensional index for predicting mortality in COPD patients.
The Body mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index is a well-known metric for chronic obstructive pulmonary disease (COPD), but it is inadequate for predicting mortality. This study proposed a new index that combines inspiratory muscle training with the BODE index and verified its ability to predict mortality in patients with COPD. ⋯ The FODEP index was more effective than the BODE index at predicting the risk of mortality in patients with COPD.