Literature DB >> 23842641

Clinical outcomes and cost analysis of exacerbations in chronic obstructive pulmonary disease.

Marc Miravitlles1, Cayo García-Polo, Adolfo Domenech, Gustavo Villegas, Francisco Conget, Cristian de la Roza.   

Abstract

BACKGROUND: Exacerbations are a major cause of disability, hospital admissions, and increased healthcare costs in patients with chronic obstructive pulmonary disease (COPD). This study investigated the clinical outcomes of outpatients with moderate to severe exacerbated COPD and their related costs.
METHODS: An observational study on the outcomes of ambulatory exacerbations of COPD was conducted. The course of the exacerbation was evaluated at a follow-up visit at 4 weeks. A cost analysis that encompassed the use of healthcare resources for treatment of the exacerbation was performed.
RESULTS: A total of 260 patients were included, with a mean age of 68.3 years and a mean FEV1 (% predicted) of 58.9 %. Twenty-two percent of patients had significant cardiovascular comorbidity. The most frequently prescribed antibiotics were moxifloxacin in 137 cases and amoxicillin-clavulanate in 50 cases. The rate of failure at 4 weeks was 12.5 %, with no differences between the two most prescribed antibiotics; however, patients treated with moxifloxacin had symptoms for 1.9 fewer days (P = 0.01). The mean cost of the exacerbation was <euro>344.96 (95 % CI: <euro>48.55-<euro>641.78), with 9.6 % of the costs for drugs and 72.9 % for hospital care of patients for whom treatment had failed.
CONCLUSIONS: Antibiotic treatment of our population was in compliance with local guidelines. The rate of failure observed in our study was lower than that reported in previous studies; however, the small percentage of patients that required hospital attention generated almost two-thirds of the total costs of the exacerbations.

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Year:  2013        PMID: 23842641     DOI: 10.1007/s00408-013-9487-z

Source DB:  PubMed          Journal:  Lung        ISSN: 0341-2040            Impact factor:   2.584


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Review 1.  Executive summary: prevention of acute exacerbation of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline.

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Authors:  Arturo Huerta; Nestor Soler; Mariano Esperatti; Mónica Guerrero; Rosario Menendez; Alexandra Gimeno; Rafael Zalacaín; Nuria Mir; Jose Maria Aguado; Antoni Torres
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9.  Cognitive status among patients with chronic obstructive pulmonary disease.

Authors:  Carlos Roncero; Ana Isabel Campuzano; Jose Antonio Quintano; Jesús Molina; Joselín Pérez; Marc Miravitlles
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10.  Cost-effectiveness of combination therapy umeclidinium/vilanterol versus tiotropium in symptomatic COPD Spanish patients.

Authors:  Marc Miravitlles; Juan B Gáldiz; Alicia Huerta; Alba Villacampa; David Carcedo; Francisco Garcia-Rio
Journal:  Int J Chron Obstruct Pulmon Dis       Date:  2016-01-18
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