Article
exacerbations and health care resource utilization in patients with airflow limitation diseases attending a primary care setting: the PUMA study
Registro en:
Montes de Oca et al, Exacerbations and health care resource utilization in patients with airflow limitation diseases attending a primary care setting: the PUMA study.Int J Chron Obstruct Pulmon Dis. 2016 Dec 7;11:3059-306
1178-2005
Autor
Montes de Oca, Maria
Aguirre, Carlos
Lopez Varela, Maria Victorina
Laucho Contreras, Maria Eugenia
Casas, Alejandro
Surmont, Filip
Institución
Resumen
Background:
COPD, asthma, and asthma–COPD overlap increase health care resource
consumption, predominantly because of hospitalization for exacerbations and also increased
visits to general practitioners (GPs) or specialists. Little information is available regarding this
in the primary care setting.
Objectives:
To describe the prevalence and number of GP and specialist visits for any cause
or due to exacerbations in patients with COPD, asthma, and asthma–COPD overlap.
Methods:
COPD was defined as post-bronchodilator forced expiratory volume in 1 second/
forced vital capacity (FEV
1
/FVC) ratio
,
0.70; asthma was defined as prior medical diagnosis,
wheezing in the last 12 months, or wheezing plus reversibility (post-bronchodilator FEV
1
or
FVC increase
$
200 mL and
$
12%); asthma–COPD overlap was defined as post-bronchodilator
FEV
1
/FVC
,
0.70 plus prior asthma diagnosis. Health care utilization was evaluated as GP
and/or specialist visits in the previous year.
Results:
Among the 1,743 individuals who completed the questionnaire, 1,540 performed
acceptable spirometry. COPD patients had a higher prevalence of any medical visits to any
physician versus those without COPD (37.2% vs 21.8%, respectively) and exacerbations doubled
the number of visits. The prevalence of any medical visits to any physician was also higher in
asthma patients versus those without asthma (wheezing: 47.2% vs 22.7%; medical diagnosis:
54.6% vs 21.6%; wheezing plus reversibility: 46.2% vs 23.8%, respectively). Asthma patients
with exacerbations had twice the number of visits versus those without an exacerbation. The
number of visits was higher (2.8 times) in asthma–COPD overlap, asthma (1.9 times), or COPD
(1.4 times) patients versus those without these respiratory diseases; the number of visits due
to exacerbation was also higher (4.9 times) in asthma–COPD overlap, asthma (3.5 times), and
COPD (3.8 times) patients.
Conclusion:
COPD, asthma, and asthma–COPD overlap increase the prevalence of medical
visits and, therefore, health care resource utilization. Attempts to reduce health care resource
use in these patients require interventions aimed at preventing exacerbations. AstraZeneca Latin America.