Jinhee Kim1, Kyungjoo Kim2, Yuri Kim2, Kwang-Ha Yoo3, Chin Kook Lee4, Hyoung Kyu Yoon5, Young Sam Kim6, Young Bum Park7, Jin Hwa Lee8, Yeon-Mok Oh9, Sang-Do Lee9, Sei Won Lee10. 1. Office of Health Services Research, National Evidence-based Healthcare Collaborating Agency, Republic of Korea. 2. Department of Research Support, National Strategic Coordinating Center for Clinical Research, Republic of Korea. 3. Department of Internal Medicine, Konkuk University School of Medicine, Republic of Korea. 4. Department of Internal Medicine, Seoul St. Mary's Hospital, Republic of Korea. 5. Department of Internal Medicine, Yeouido St. Mary's Hospital, Republic of Korea. 6. Department of Internal Medicine, Yonsei University College of Medicine, Republic of Korea. 7. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Republic of Korea. 8. Department of Internal Medicine, School of Medicine, Ewha Women's University, Seoul, Republic of Korea. 9. Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea. 10. Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea. Electronic address: iseiwon@gmail.com.
Abstract
BACKGROUND: Although the efficacy of inhaled long-acting bronchodilators has been well documented in randomised controlled studies, whether similar effects are obtained in real-life clinical practice is not clear. In this study, we analysed the effect of inhaled long-acting bronchodilators in newly-diagnosed COPD patients. METHODS: The Korean Health Insurance Review and Assessment Service databases were used. Participants ≥40-years-old who had not been diagnosed with COPD between 2007 and 2008 but were diagnosed and prescribed COPD medication in 2009 were designated as newly-diagnosed COPD patients. Patients were divided into three groups based on the use of bronchodilators, an inhaled long-acting bronchodilator (LA-B), an inhaled short-acting bronchodilator (SA-B) and an oral medication (OM) group. RESULTS: A total of 77,480 newly-diagnosed COPD patients with a mean age of 68.5 years, among which 43,530 (56.2%) were men, were included in the study. ER visits and hospitalisation were associated with SA-B group, male gender, older age, Medicaid coverage, tertiary healthcare centre visits and higher comorbidities. Multivariate analysis showed that the SA-B group was associated with more ER visits, recurrent ER visits, hospitalisation and recurrent hospitalisation (adjusted ORs [95% confidence intervals] = 4.32 [3.93-4.75], 6.19 [5.24-7.30], 5.04 [2.95-3.39], and 8.49 [7.67-9.39], respectively) compared with the LA-B group. Medical utilisation cost was also higher in the SA-B group. CONCLUSION: Inhaled long-acting bronchodilator use was associated with lower rates of hospitalisation, fewer ER visits and lower medical costs in newly-diagnosed COPD patients in real-life clinical practice.
BACKGROUND: Although the efficacy of inhaled long-acting bronchodilators has been well documented in randomised controlled studies, whether similar effects are obtained in real-life clinical practice is not clear. In this study, we analysed the effect of inhaled long-acting bronchodilators in newly-diagnosed COPDpatients. METHODS: The Korean Health Insurance Review and Assessment Service databases were used. Participants ≥40-years-old who had not been diagnosed with COPD between 2007 and 2008 but were diagnosed and prescribed COPD medication in 2009 were designated as newly-diagnosed COPDpatients. Patients were divided into three groups based on the use of bronchodilators, an inhaled long-acting bronchodilator (LA-B), an inhaled short-acting bronchodilator (SA-B) and an oral medication (OM) group. RESULTS: A total of 77,480 newly-diagnosed COPDpatients with a mean age of 68.5 years, among which 43,530 (56.2%) were men, were included in the study. ER visits and hospitalisation were associated with SA-B group, male gender, older age, Medicaid coverage, tertiary healthcare centre visits and higher comorbidities. Multivariate analysis showed that the SA-B group was associated with more ER visits, recurrent ER visits, hospitalisation and recurrent hospitalisation (adjusted ORs [95% confidence intervals] = 4.32 [3.93-4.75], 6.19 [5.24-7.30], 5.04 [2.95-3.39], and 8.49 [7.67-9.39], respectively) compared with the LA-B group. Medical utilisation cost was also higher in the SA-B group. CONCLUSION: Inhaled long-acting bronchodilator use was associated with lower rates of hospitalisation, fewer ER visits and lower medical costs in newly-diagnosed COPDpatients in real-life clinical practice.
Authors: Kyoung Hee Cho; Young Sam Kim; Chung Mo Nam; Tae Hyun Kim; Sun Jung Kim; Kyu-Tae Han; Eun-Cheol Park Journal: BMJ Open Date: 2015-11-30 Impact factor: 2.692
Authors: Seon Cheol Park; Dong Wook Kim; Eun Cheol Park; Cheung Soo Shin; Chin Kook Rhee; Young Ae Kang; Young Sam Kim Journal: Korean J Intern Med Date: 2019-10-16 Impact factor: 2.884
Authors: Yong Suk Jo; Kwang Ha Yoo; Yong Bum Park; Chin Kook Rhee; Ki Suck Jung; Seung Hun Jang; Ji Young Park; Youlim Kim; Bo Yeon Kim; Sang In Ahn; Yon U Jo; Yong Il Hwang Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-06-12