Projecting Long-term Health and Economic Burden of COPD in the United States

Zafarí, Zafar; Li, Shukai; Eakin, Michelle N.; Bellanger, Martine; Reed, Robert M.

doi:10.1016/j.chest.2020.09.255

Cited by 74 publications

(56 citation statements)

References 22 publications

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“… 37 , 38 The socio-economic burden of COPD is high. 6 , 7 2. Assessment of disease and risk quantification Symptom assessment using mMRC and or CAT score and exacerbation history to inform and guide therapy.…”

Section: Resultsmentioning

confidence: 99%

“… 6 The socio-economic burden of COPD is also high, with projected 20-year (2019–2038) discounted direct and indirect costs estimated at $801 billion and $101 billion, respectively, in the USA. 6 Similarly, the average total annual per patient cost of COPD management (excluding medications) in the United Kingdom has been estimated at £3396 for those experiencing ≥2 moderate-to-severe exacerbations. Primary care associated costs contribute most to overall expenditure.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] COPD is projected to be responsible for a loss of 45 million qualityadjusted life years, 315 million exacerbations, and 9 million deaths cumulatively in the USA over the next 20 years, assuming current patterns of treatment and smoking rates. 6 The socio-economic burden of COPD is also high, with projected 20-year (2019-2038) discounted direct and indirect costs estimated at $801 billion and $101 billion, respectively, in the USA. 6 Similarly, the average total annual per patient cost of COPD management (excluding medications) in the United Kingdom has been estimated at £3396 for those experiencing ≥2 moderate-to-severe exacerbations.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

CONQUEST Quality Standards: For the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of COPD Care

Pullen¹,

Miravitlles²,

Sharma³

et al. 2021

COPD

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Background Chronic obstructive pulmonary disease (COPD) are managed predominantly in primary care. However, key opportunities to optimize treatment are often not realized due to unrecognized disease and delayed implementation of appropriate interventions for both diagnosed and undiagnosed individuals. The COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) is the first-of-its-kind, collaborative, interventional COPD registry. It comprises an integrated quality improvement program focusing on patients (diagnosed and undiagnosed) at a modifiable and higher risk of COPD exacerbations. The first step in CONQUEST was the development of quality standards (QS). The QS will be imbedded in routine primary and secondary care, and are designed to drive patient-centered, targeted, risk-based assessment and management optimization. Our aim is to provide an overview of the CONQUEST QS, including how they were developed, as well as the rationale for, and evidence to support, their inclusion in healthcare systems. Methods The QS were developed (between November 2019 and December 2020) by the CONQUEST Global Steering Committee, including 11 internationally recognized experts with a specialty and research focus in COPD. The process included an extensive literature review, generation of QS draft wording, three iterative rounds of review, and consensus. Results Four QS were developed: 1) identification of COPD target population, 2) assessment of disease and quantification of future risk, 3) non-pharmacological and pharmacological intervention, and 4) appropriate follow-up. Each QS is followed by a rationale statement and a summary of current guidelines and research evidence relating to the standard and its components. Conclusion The CONQUEST QS represent an important step in our aim to improve care for patients with COPD in primary and secondary care. They will help to transform the patient journey, by encouraging early intervention to identify, assess, optimally manage and followup COPD patients with modifiable high risk of future exacerbations.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CONQUEST Quality Standards: For the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of COPD Care

Pullen¹,

Miravitlles²,

Sharma³

et al. 2021

COPD

View full text Add to dashboard Cite

show abstract

“…2 In 2019, 8% of Americans aged 18 years and over, and 7% of children younger than 18 years were diagnosed with asthma. 3 Despite the significant health and economic toll that COPD and asthma take on society, 4,5 to date, there is no definite cure for these conditions. Nevertheless, there are effective inhalers to subdue symptoms of these respiratory diseases if patients stay adherent to them.…”

Section: What This Study Addsmentioning

confidence: 99%

Trends in Medicaid spending on inhalers in the United States, 2012-2018

Sistani

Reed

Shah

et al. 2021

JMCP

Self Cite

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“…3 COPD is the fourth leading cause of mortality in the United States, 4 and is projected to be responsible for 9.42 million deaths and more than $800 billion in direct medical costs by 2038. 5…”

Section: Introductionmentioning

confidence: 99%

Electronic Nicotine Delivery Systems (ENDS) use during a five-year period is not associated with self-reported chronic obstructive pulmonary disease (COPD) after adjustment of cigarette smoking history: A longitudinal analysis of PATH data

Cook

Hirschtick

Fleischer

et al. 2022

Preprint

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Background: Understanding the relationship between electronic nicotine delivery systems (ENDS) use and chronic obstructive pulmonary disease (COPD) and other respiratory conditions is critical. However, previous studies have not adequately controlled for history of cigarette smoking. Research Question: To examine the prospective association between ENDS use and self-reported incident COPD after adjusting for cigarette smoking history. Study Design and Methods: Using waves 1-5 of the US Population Assessment of Tobacco and Health (PATH) study, we examined the association between ENDS use and self-reported incident COPD among adults aged 40+ using discrete time survival models. Current ENDS use was measured as a time-varying covariate, lagged by one wave, defined as established daily or some days use. We controlled for baseline demographics (age, sex, race/ethnicity, education), health characteristics (asthma, obesity, exposure to second-hand smoke), and smoking history (smoking status and cigarette pack-years). Results: Incident COPD was self-reported by 925 respondents during the five-year follow-up period. Prior to adjusting for other covariates, time-varying ENDS use appeared to nearly double the risk of incident COPD (HR 1.98, 95% CI 1.44-2.74). However, ENDS use was no longer significantly associated with COPD (aHR 1.10, 95% CI 0.78-1.57) after adjusting for current cigarette smoking and cigarette pack-years. The risk of self-reported incident COPD increased with cigarette pack-years and was higher for respondents who were older, female, less educated, and had baseline asthma or obesity. Interpretation: ENDS use did not significantly increase the risk of self-reported incident COPD over a five-year period once current smoking status and cigarette pack-years were taken into account. Cigarette pack-years, on the other hand, remained associated with a net increase in the risk of self-reported incident COPD. These findings highlight the importance of using prospective longitudinal data and properly controlling for cigarette smoking history to assess the independent health effects of ENDS.

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Projecting Long-term Health and Economic Burden of COPD in the United States

Cited by 74 publications

References 22 publications

CONQUEST Quality Standards: For the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of COPD Care

CONQUEST Quality Standards: For the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of COPD Care

Trends in Medicaid spending on inhalers in the United States, 2012-2018

Electronic Nicotine Delivery Systems (ENDS) use during a five-year period is not associated with self-reported chronic obstructive pulmonary disease (COPD) after adjustment of cigarette smoking history: A longitudinal analysis of PATH data

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