Mortality trends in chronic obstructive pulmonary disease in Europe, 1994–2010: a joinpoint regression analysis

Lόpez-Campos, José Luís; Ruíz-Ramos, Miguel; Soriano, Joan B.

doi:10.1016/s2213-2600(13)70232-7

Cited by 135 publications

(101 citation statements)

References 29 publications

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“…In agreement with this, our results show that the total number of deaths from COPD in Italy remained stable in men and even increased in women, despite the age-adjusted rates of COPD mortality significantly decreasing in the last 30 years. Similar trends were shared by other European Union (EU) countries and Japan [12, 13]. As noted by B urney et al [1], the apparent paradox of the decreasing ASRs and increasing numbers of death can be easily explained by the modification in the age structure of the population.…”

Section: Discussionsupporting

confidence: 63%

Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age–period–cohort analysis

Pesce

2016

ERJ Open Res

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Chronic lower respiratory diseases (CLRDs) are a major cause of morbidity and mortality worldwide. The objectives of this study were to estimate the trends in CLRD mortality in Italy, and the specific contributions of age, time period and birth cohort in driving these trends.Population and cause-of-death data in Italy between 1979 and 2010 were collected from the World Health Organization website. Age-specific mortality rates for CLRDs, and effects for age, time period and birth cohort on mortality trends were estimated using age–period–cohort models.Chronic obstructive pulmonary disease (COPD) and chronic bronchitis represent nearly 98% of the deaths from CLRDs. Despite the overall number of deaths have been stable (in men) or increasing (in women), the age-standardised rates have been steadily decreasing from 1979 to 2010, passing from 104.3 to 55.4 per 100 000 person-years in men and from 32.2 to 19.6 per 100 000 person-years in women. The average relative annual decrease was −3.6% in men and −2.7% in women. Since the end of the 1990s, the decreasing trend of CLRD mortality has started to level off, in particular in women. The decrease in CLRD mortality rates has been more accentuated in more recent cohorts and in younger age groups.Both birth cohort and time period significantly affected the CLRD mortality rates, suggesting that changes in the spread of risk factors (smoking habits, early-life and occupational exposures) across different birth cohorts, as well as in advanced in healthcare and medical practice, may have played a major role in secular changes in COPD mortality rates in Italy.

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Section: Discussionsupporting

confidence: 63%

Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age–period–cohort analysis

Pesce

2016

ERJ Open Res

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“…Women are known to be more susceptible to developing COPD [29] and have less declining COPD-related mortality rates than men [30], but factors influencing sex differences in treatment are still an understudied area. Women have been reported to have more symptoms and more exacerbations in COPD [31], but as our analyses adjusted for both CAT and CCQ scores and for previous frequent exacerbations, difference in these factors should not explain the increased medication in women in 2014.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing pharmacological treatment in COPD: a comparison of 2005 and 2014

Sundh

Åberg

Hasselgren

et al. 2017

European Clinical Respiratory Journal

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Introduction: The aim was to investigate how the pattern of pharmacological treatment in Swedish patients with chronic obstructive pulmonary disease (COPD) has changed over a decade, and to identify factors associated with treatment. Methods: Data on patient characteristics and pharmacological treatment were collected using questionnaires from two separate cohorts of randomly selected primary and secondary care patients with a doctor’s diagnosis of COPD in central Sweden, in 2005 (n = 1111) and 2014 (n = 1329). Cross-tabulations and chi-square tests were used to compare maintenance treatment in 2005 and 2014, and to investigate the distribution of treatment by the 2017 Global Initiative for Obstructive Lung Disease (GOLD) ABCD groups. Multinomial logistic regression was used to analyze associations with the major types of recommended treatments: bronchodilator therapy, combined long-acting beta-2-antagonists (LABA) + inhaled corticosteroids (ICS), and triple inhaled therapy. Results: The proportion of patients with no maintenance treatment, with only LABA + ICS, and with sole ICS statistically significantly decreased (36 vs. 31%, 16 vs. 12% and 5 vs. 2%, respectively), and the proportion with triple inhaled therapy statistically significantly increased (29 vs. 40%). In 2014, triple inhaled therapy was the most common treatment in all GOLD groups except group A. In 2014, previous frequent exacerbations [OR (95% CI) 2.34 (1.62 to 3.36)], worse COPD Assessment Test score [1.07 (1.05 to 1.09)], female sex [2.13 (1.56 to 2.91)], and access to a specific responsible doctor [1.95 (1.41 to 2.69)] were associated with triple inhaled therapy. Current smoking [0.40 (0.28 to 0.57)] and overweight [0.62 (0.41 to 0.93)] were inversely associated with triple inhaled therapy. Conclusions: Over the last decade, triple inhaled therapy has increased, and no maintenance treatment, ICS, or LABA + ICS has decreased. Triple inhaled therapy is the most common treatment and is associated with previous exacerbations, higher symptom level, female sex, and having a specific responsible doctor.

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“…Many descriptions of national and regional mortality trends over time have been published previously [7][8][9][10][11][12][13][14]. These have reported variable trends, mostly at a local level, and have rarely analysed the drivers of change.…”

Section: Introductionmentioning

confidence: 99%

Global and regional trends in COPD mortality, 1990–2010

et al. 2015

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Between 1990 and 2010, chronic obstructive pulmonary disease (COPD) moved from the fourth to third most common cause of death worldwide.Using data from the Global Burden of Disease programme we quantified regional changes in the number of COPD deaths and COPD mortality rates between 1990 and 2010. We estimated the proportion of the change that was attributable to gross national income per capita and an index of cumulative smoking exposure, and quantified the difference in mortality rates attributable to demographic changes.Despite a substantial decrease in COPD mortality rates, COPD deaths fell only slightly, from three million in 1990 to 2.8 million in 2010, because the mean age of the population increased. The number of COPD deaths in 2010 would have risen to 5.2 million if the age-and sex-specific mortality rates had remained constant. Changes in smoking led to only a small increase in age-and sex-specific mortality rates, which were strongly associated with changes in gross national income.The increased burden of COPD mortality was mainly driven by changes in age distribution, but ageand sex-specific rates fell as incomes rose. The rapid response to increasing affluence suggests that changes in COPD mortality are not entirely explained by changes in early life. @ERSpublications COPD age-standardised mortality rates decrease as incomes increase, but COPD deaths increase as population ages

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Mortality trends in chronic obstructive pulmonary disease in Europe, 1994–2010: a joinpoint regression analysis

Cited by 135 publications

References 29 publications

Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age–period–cohort analysis

Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age–period–cohort analysis

Factors influencing pharmacological treatment in COPD: a comparison of 2005 and 2014

Global and regional trends in COPD mortality, 1990–2010

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