Clinical and economic outcomes of multiple versus single long-acting inhalers in COPD.
Respir Med
; 105(12): 1861-71, 2011 Dec.
Article
em En
| MEDLINE
| ID: mdl-21807487
ABSTRACT
OBJECTIVE:
To compare healthcare resource utilization and healthcare costs between COPD patients who used multiple long-acting inhalers versus those who used a single long-acting inhaler.METHODS:
COPD patients meeting study inclusion criteria were identified in the Market Scan database (2004-2008) and were classified as being a multiple- or single-inhaler user. 11,747 multiple- and single-inhaler users were matched on baseline characteristics to balance disease severity. Patients were followed for 12 months. Incremental differences between the two groups were estimated for number of exacerbations; time to first exacerbation; all-cause and COPD-related inpatient admissions, inpatient days, emergency room visits, urgent care visits, outpatient visits, and other medical services visits; all-cause and COPD-related healthcare costs. Multivariate regression analyses were also used to control for a number of potentially confounding factors.RESULTS:
After controlling for a number of potentially confounding factors, multiple-inhaler users experienced significantly more exacerbations (0.52; p < .0001) and had a higher risk of exacerbation (HR = 1.40; p < .0001) than single-inhaler users. Multiple-inhaler users also incurred significantly more inpatient admissions (IRR = 1.15; p < .0001), inpatient days (IRR = 1.20; p < .0001), urgent care visits (IRR = 1.10; p = 0.0026), outpatient visits (IRR = 1.06; p < .0001), and other medical services visits (IRR = 1.12; p = <.001) than single-inhaler users, resulting in significantly higher all-cause health care costs ($3,319; p < .0001). Results of COPD-related resource use and costs were comparable.CONCLUSIONS:
After controlling for a number of potentially confounding factors, multiple-inhaler users had more exacerbations, a higher risk of exacerbation, and higher healthcare resource utilization and costs compared to single-inhaler users.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Broncodilatadores
/
Custos de Cuidados de Saúde
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Doença Pulmonar Obstrutiva Crônica
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Adesão à Medicação
/
Hospitalização
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
/
Male
Idioma:
En
Revista:
Respir Med
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos