The influence of heart disease on characteristics, quality of life, use of health resources, and costs of COPD in primary care settings

<p>Abstract</p> <p>Background</p> <p>To evaluate the influence of heart disease on clinical characteristics, quality of life, use of health resources, and costs of patients with COPD followed at primary care settings under common clinical practice conditions.</p> <p>Methods</p> <p>Epidemiologic, observational, and descriptive study (EPIDEPOC study). Patients ≥ 40 years of age with stable COPD attending primary care settings were included. Demographic, clinical characteristics, quality of life (SF-12), seriousness of the disease, and treatment data were collected. Results were compared between patients with or without associated heart disease.</p> <p>Results</p> <p>A total of 9,390 patients with COPD were examined of whom 1,770 (18.8%) had heart disease and 78% were males. When comparing both patient groups, significant differences were found in the socio-demographic characteristics, health profile, comorbidities, and severity of the airway obstruction, which was greater in patients with heart disease. Differences were also found in both components of quality of life, physical and mental, with lower scores among those patients with heart disease. Higher frequency of primary care and pneumologist visits, emergency-room visits and number of hospital admissions were observed among patients with heart diseases. The annual total cost per patient was significantly higher in patients with heart disease; 2,937 ± 2,957 vs. 1,749 ± 2,120, p < 0.05. Variables that were showed to be independently associated to COPD in subjects with hearth conditions were age, being inactive, ex-smokers, moderate physical exercise, body mass index, concomitant blood hypertension, diabetes, anxiety, the SF-12 physical and mental components and per patient per year total cost.</p> <p>Conclusion</p> <p>Patients with COPD plus heart disease had greater disease severity and worse quality of life, used more healthcare resources and were associated with greater costs compared to COPD patients without known hearth disease.</p

Determinants and predictors of the cost of COPD in primary care: A Spanish perspective

Javier de Miguel Diez1, Pilar Carrasco Garrido2, Marta Garc&amp;iacute;a Carballo2, Angel Gil de Miguel2, Javier Rejas Gutierrez3, Jos&amp;eacute; M Bell&amp;oacute;n Cano4, Valent&amp;iacute;n Hern&amp;aacute;ndez Barrera2, Rodrigo Jimenez Garc&amp;iacute;a21Department of Pneumology, University Hospital Gregorio Mara&amp;ntilde;&amp;oacute;n, Madrid, Spain; 2School of Health Sciences, Rey Juan Carlos University, Alcorc&amp;oacute;n (Madrid), Spain; 3Health Outcomes Research Department Medical Unit, Pfizer Spain, Alcobendas (Madrid), Spain; 4Department of Preventive Medicine, University Hospital Gregorio Mara&amp;ntilde;&amp;oacute;n, Madrid, SpainObjectives: 1) To estimate the annual cost of patients with stable chronic obstructive pulmonary disease (COPD) followed in primary care in Spain; 2) To analyze the possible cost predictor variables.Patients and methods: A multicenter, epidemiological, observational, descriptive study. Sociodemographic data, severity of disease, associated comorbidity, treatment followed by patients, quality of life (SF-12 questionnaire), health care resource utilization in the previous 12 months and duration of working disability due to COPD were collected.Results: A total of 10,711 patients (75.6% men; 24.4% women) with a mean age of 67.1 &amp;plusmn; 9.66 years were evaluated. The mean forced expiratory volume in one second (FEV1) value was 57.4 &amp;plusmn; 13.4%. The total cost per patient per year was &amp;euro;1,922.60 &amp;plusmn; 2,306.44. The largest component of this cost was hospitalization (&amp;euro;788.72 &amp;plusmn; 1,766.65), followed by cost of drugs (&amp;euro;492.87 &amp;plusmn; 412.15) and visits to emergency rooms (&amp;euro;134.32 &amp;plusmn; 195.44). Linear regression analysis found associated heart disease, FEV1, physical component of quality of life, number of medical visits (primary care physician, pneumologist and emergency room), hospital admissions (frequency and duration of stay) and duration of working disability to be significant predictors of the total annual cost.Conclusions: The total annual cost of a COPD patient followed in primary care in Spain was considered high in this study. The presence of associated heart disease, severity of airflow obstruction, physical component of quality of life, health care resource utilization and duration of work disability were found to be predictor of cost.Keywords: COPD, primary care, costs, predictors, Spai

Characteristics of chronic obstructive pulmonary disease in Spain from a gender perspective

Abstract Background The objective of this study was to analyze the clinical and management characteristics of chronic obstructive pulmonary disease (COPD) in men and women, to determine possible gender-associated differences between the two groups of patients. Methods An observational and descriptive epidemiological study (EPIDEPOC study). The study included patients with stable COPD and aged ≥ 40 years, evaluated in primary care. Data were collected relating to sociodemographic variables, clinical characteristics, quality of life (SF-12), severity of disease and treatment. The results obtained in men and women were compared. Results A total of 10,711 patients (75.6% males and 24.4% females) were evaluated. Significant differences were found between males and females in relation to the following parameters: age (67.4 ± 9.2 years in men vs 66.1 ± 10.8 in women, p 2-adrenergic agonists, anticholinergic agents, theophyllines and mucolytic agents was significant greater in men. The total annual cost of COPD was greater in males than in females (1989.20 ± 2364.47 € vs 1724.53 ± 2106.90, p Conclusion The women with COPD evaluated in this study were younger, smoked less and have more comorbidity, a poorer quality of life, and lesser disease severity than men with COPD. However, they generated a lesser total annual cost of COPD than men.</p