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The association between inhaled long-acting bronchodilators and less in-hospital care in newly-diagnosed COPD patients

2013; Elsevier BV; Volume: 108; Issue: 1 Linguagem: Inglês

10.1016/j.rmed.2013.08.003

1532-3064

Jinhee Kim, Kyungjoo Kim, Yuri Kim, Kwang Ha Yoo, Chin Kook Lee, Hyoung Kyu Yoon, Young Sam Kim, Yong Bum Park, Jin Hwa Lee, Yeon‐Mok Oh, Sang‐Do Lee, Sei Won Lee,

Asthma and respiratory diseases

BackgroundAlthough the efficacy of inhaled long-acting bronchodilators has been well documented in randomised controlled studies, whether similar effects are obtained in real-life clinical practice is not clear. In this study, we analysed the effect of inhaled long-acting bronchodilators in newly-diagnosed COPD patients.MethodsThe Korean Health Insurance Review and Assessment Service databases were used. Participants ≥40-years-old who had not been diagnosed with COPD between 2007 and 2008 but were diagnosed and prescribed COPD medication in 2009 were designated as newly-diagnosed COPD patients. Patients were divided into three groups based on the use of bronchodilators, an inhaled long-acting bronchodilator (LA-B), an inhaled short-acting bronchodilator (SA-B) and an oral medication (OM) group.ResultsA total of 77,480 newly-diagnosed COPD patients with a mean age of 68.5 years, among which 43,530 (56.2%) were men, were included in the study. ER visits and hospitalisation were associated with SA-B group, male gender, older age, Medicaid coverage, tertiary healthcare centre visits and higher comorbidities. Multivariate analysis showed that the SA-B group was associated with more ER visits, recurrent ER visits, hospitalisation and recurrent hospitalisation (adjusted ORs [95% confidence intervals] = 4.32 [3.93–4.75], 6.19 [5.24–7.30], 5.04 [2.95–3.39], and 8.49 [7.67–9.39], respectively) compared with the LA-B group. Medical utilisation cost was also higher in the SA-B group.ConclusionInhaled long-acting bronchodilator use was associated with lower rates of hospitalisation, fewer ER visits and lower medical costs in newly-diagnosed COPD patients in real-life clinical practice.