Hospital Universitario de Bellvitge.L’Hospitalet de Llobregat (Barcelona)

Dr. Joan Valldeperas

[ERS] The healthcare burden of non-compliance to pharmacotherapeutic escalation

recommendations for COPD

Tavares R, Zhang S, Dang-Tan T, Ismaila A, Stutz M, Coletta N, et al.

Mesa 1

To describe the healthcare burden associated with not escalating patients with COPD managed with LAMA or LABA monotherapy or LAMA/LABA dual therapy to ICS/LAMA/LABA following a moderate or severe exacerbation.

This observational study utilised medical claims from the Quebec Provincial Health Insurance administrative database.

Included were patients ≥40 years of age with an incident diagnosis of COPD (during 2002–2011) receiving a respiratory medicine within 2 weeks of a COPD claim and treated with a LAMA, LABA or LAMA/LABA without a preceding moderate or severe exacerbation in 2 years preciding.

The study cohort were followed for a median of 3.56 years after the first exacerbation.

Multivariate-adjusted outcomes included incidence density rates for moderate or severe COPD exacerbations and healthcare utilisation, stratified by escalation to ICS/LAMA/LABA triple therapy following an exacerbation.

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Tasa de densidad de incidencia

Overall, 19,198 (49.5%) patients experienced COPD exacerbations. Of these, 1,136 (5.9%) were escalated to triple therapy following an exacerbation. Compared with patients switched to triple therapy, those not escalated experienced increased mean incidence density rates (per 100 person-years) for future exacerbations (any: 0.21 vs 0.18, p<0.001; moderate: 0.10 vs 0.07, p<0.001), ER visits (0.11 vs 0.10, p<0.05), and greater use of antibiotics, oral corticosteroids and rescue medications (0.94 vs 0.79, 0.76 vs 0.66, 1.08 vs 0.50; p<0.001). Hospitalisation rates were similar among patients treated with triple therapy. Other outcomes were similar between groups.

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Failure to escalate to ICS/LAMA/LABA triple therapy following an exacerbation results in increased exacerbations, ER visits and concomitant medication use in patients with COPD.

Funded by GSK: HO-13-14097.

[ERS] The healthcare burden of non-compliance to pharmacotherapeutic escalation

recommendations for COPD

Rivera-Ortega P, González J, Restituto P, Varo N, Colina I, et al.

Mesa 1

Smoking Definitions Never Smokers – Adults who have never smoked a cigarette or who smoked fewer than 100 cigarettes in their entire lifetime.Former Smokers – Adults who have smoked at least 100 cigarettes in their lifetime, but say they currently do not smoke.Nonsmokers – Adults who currently do not smoke cigarettes, including both former smokers and never smokers.Current Smokers – Adults who have smoked 100 cigarettes in their lifetime and currently smoke cigarettes every day (daily) or some days (nondaily).