gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Health care costs in COPD: misuse of resources as a consequence of over-diagnosed disease

Meeting Abstract

  • Gertraud Weiß - Universitätsklinik für Pneumologie, Landeskrankenhaus Salzburg, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg
  • Bernd Lamprecht - Universitätsklinik für Pneumologie, Landeskrankenhaus Salzburg, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg
  • Bernhard Kaiser - Universitätsklinik für Pneumologie, Landeskrankenhaus Salzburg, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg
  • Michael Studnicka - Universitätsklinik für Pneumologie, Landeskrankenhaus Salzburg, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds033

doi: 10.3205/11gmds033, urn:nbn:de:0183-11gmds0331

Published: September 20, 2011

© 2011 Weiß et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

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.


References

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Buist AS, Vollmer WM, Sullivan SD, et al. The Burden of Obstructive Lung Disease Initiative (BOLD): Rationale and Design. COPD. 2005;2:277-83.
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Schirnhofer l, Lamprecht B, Vollmer W, Allison M, Studnicka M, Jensen R, Buist S. COPD Prevalence in Salzburg (Austria); Results from the Burden of Obstructive Lung Disease (BOLD) Study. Chest. 2007;131:29-36.
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Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructuve Pulmonary Disease. Available from: http://www.goldcopd.com [accessed: 14th April 2011] External link