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

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

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Although 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. Methods: The 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. Results: A 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. Conclusion: Inhaled 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.

Original languageEnglish
Pages (from-to)153-161
Number of pages9
JournalRespiratory Medicine
Volume108
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Chronic obstructive pulmonary disease
  • Long-acting bronchodilator
  • Medical cost
  • Medical utilisation

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