Artikel
Health care costs in COPD: misuse of resources as a consequence of over-diagnosed disease
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Veröffentlicht: | 20. September 2011 |
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Introduction: COPD is projected the third most common cause in mortality worldwide in 2020. Besides, COPD causes and will cause enormous direct medical costs associated with medication and hospitalizations. These interventions should be targeted to patients, who are likely to benefit. We investigated the use of respiratory medication with regard to the presence of non-reversible airways obstruction.
Methods: We used the spirometry and questionnaire data as collected for the Austrian sample of the international BOLD (Burden of obstructive lung disease) study. We investigated whether the use of respiratory medication was associated with post-bronchodilator non-reversible airways obstruction, a doctor’s prior diagnosis of COPD, and a reported prior spirometry. 50 of 53 (94.3%) who have non-reversible airways obstruction stated to take short- acting bronchodilators (SABA) (N=27), long- acting bronchodilators (LABA) (N=37), inhaled glucocorticosteroids (ICS) (N=5) and/or methylxantines (N=7). In 22 cases (38%) respiratory medication is used that is not according to the GOLD- guidelines for COPD stage specific pharmacologic treatment.
Results: Altogether 1,258 individuals completed the study protocol. For 80 participants the prior use of any respiratory medication in the last 12 months was recorded. However, only 53 of 80 (66.3%) demonstrated post-bronchodilator non-reversible airways obstruction (FEV1/FVC < 0.7), and 24 of 80 (30%) reported a prior doctor’s diagnosis of COPD, and only 62 of 80 (77.5%) reported a prior spirometry test.
Conclusions: Our findings indicate that a substantial proportion of health care costs due to respiratory medication are spent on subjects without COPD. These costs could be greatly reduced when spirometric results would be required for the prescription of respiratory medication.
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