Projecting the COPD population and costs in England and Scotland: 2011 to 2030

McLean, Susannah; Hoogendoorn, Martine; Hoogenveen, Rudolf T.; Feenstra, Talitha; Wild, Sarah; Simpson, Colin R; Mölken, Maureen P. M. H. Rutten-van; Sheikh, Aziz

doi:10.1038/srep31893

Cited by 61 publications

(52 citation statements)

References 22 publications

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“…Despite the preventable and treatable nature of the condition 3 , it poses a high financial burden to the healthcare systems globally. In England, the annual direct healthcare costs of COPD were estimated to be £1.5 billion in 2011, with severe exacerbations costing £3726 per event 4 . There are also substantial indirect and intangible costs associated with COPD, which are much harder to quantify, but include time lost from work, impact on family, and additional social and care costs 5 .…”

Section: Introductionmentioning

confidence: 99%

Are COPD self-management mobile applications effective? A systematic review and meta-analysis

Shaw

Whelan

Armitage

et al. 2020

npj Prim. Care Respir. Med.

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The burden of chronic obstructive pulmonary disease (COPD) to patients and health services is steadily increasing. Selfmanagement supported by mobile device applications could improve outcomes for people with COPD. Our aim was to synthesize evidence on the effectiveness of mobile health applications compared with usual care. A systematic review was conducted to identify randomized controlled trials. Outcomes of interest included exacerbations, physical function, and Quality of Life (QoL). Where possible, outcome data were pooled for meta-analyses. Of 1709 citations returned, 13 were eligible trials. Number of exacerbations, quality of life, physical function, dyspnea, physical activity, and self-efficacy were reported. Evidence for effectiveness was inconsistent between studies, and the pooled effect size for physical function and QoL was not significant. There was notable variation in outcome measures used across trials. Developing a standardized outcome-reporting framework for digital health interventions in COPD self-management may help standardize future research.npj Primary Care Respiratory Medicine (2020) 30:11 ; https://doi.

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Section: Introductionmentioning

confidence: 99%

Are COPD self-management mobile applications effective? A systematic review and meta-analysis

Shaw

Whelan

Armitage

et al. 2020

npj Prim. Care Respir. Med.

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“…The increasing frequency of emergency department attendances and emergency hospital admissions in England may result in slower intra‐hospital transfer times and a longer time to initiate NIV. This study highlights a possible need for quality improvement to meet the recently published BTS ‘Quality Standards for acute NIV in adults’ statement: ‘Patients who meet evidence‐based criteria for acute NIV should start NIV within 60 minutes of the blood gas result associated with the clinical decision to provide NIV and within 120 minutes of hospital arrival for patients who present acutely’ The observation that there were fewer males in Cohort 2 was unexpected and may reflect an increasing prevalence of COPD in females in England …”

Section: Discussionmentioning

confidence: 79%

Temporal trends in survival following ward‐based NIV for acute hypercapnic respiratory failure in patients with COPD

Trethewey

Edgar

Morlet

et al. 2019

Clinical Respiratory J

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Introduction Non‐invasive ventilation (NIV) is recommended for treatment of acute hypercapnic respiratory failure (AHRF) in acute exacerbations of COPD. National UK audit data suggests that mortality rates are rising in COPD patients treated with NIV. Objective To investigate temporal trends in in‐hospital mortality in COPD patients undergoing a first episode of ward‐based NIV for AHRF. Methods Retrospective study of hospitalised COPD patients treated with a first episode of ward‐based NIV at a large UK teaching hospital between 2004 and 2017. Patients were split into two cohorts based on year of admission, 2004‐2010 (Cohort 1) and 2013‐2017 (Cohort 2), to facilitate comparison of patient characteristics. Results In total, 547 unique patients were studied. There was no difference in in‐hospital mortality rate between the time periods studied (17.6% vs 20.5%, P = .378). In Cohort 2 there were more females, a higher rate of co‐morbid bronchiectasis and pneumonia on admission and more severe acidosis, hypercapnia and hypoxia. More patients in Cohort 2 had NIV as the ceiling of treatment. Patients in Cohort 2 experienced a longer time from AHRF diagnosis to application of NIV, higher maximum inspiratory positive airway pressure, lower maximum oxygen and shorter duration of NIV. Finally, patients in Cohort 2 experienced a shorter hospital length of stay (LOS), with no differences observed in rate of transfer to critical care or intubation. Conclusion In‐hospital mortality remained stable and LOS decreased over time, despite greater comorbidity and more severe AHRF in COPD patients treated for the first time with ward‐based NIV.

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“…2,3 A 2016 UK study estimated that COPD prevalence will increase from 1·79% to 2·19% in England and 2·03% to 2·20% in Scotland from 2011-30, with a projected total health cost of £2·53 billion by 2030. 4 Exposure to air pollution is one of the main triggers for symptoms of COPD and its exacerbation. [5][6][7][8][9] Outdoor PM 2·5 , in particular, poses considerable health risks, being the fifth leading risk factor for death globally.…”

Section: Introductionmentioning

confidence: 99%

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

Sarkar

Zhang

et al. 2019

The Lancet Planetary Health

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Background The role of environmental exposures in chronic obstructive pulmonary disease (COPD) remains inconclusive. We examined the association between environmental exposures (PM 2·5 , greenness, and urbanicity) and COPD prevalence using the UK Biobank cohort data to identify key built environment correlates of COPD. MethodsIn this cross-sectional, observational study we used baseline data for UK Biobank participants. Included participants were aged 39 years and older, white, had available spirometry data, and had complete data for phenotypes and exposures. COPD was defined by spirometry with the 2017 Global Initiative for Chronic Obstructive Lung Disease criteria. Environmental exposures were PM 2·5 derived from monitoring data and interpolated using land-use regression at the participants' geocoded residential addresses. Built environment metrics of residential greenness were modelled in terms of normalised difference vegetation index from remotely sensed colour infrared data within a 500 m residential catchment, and an urbanicity index derived from spatial analyses and measured with a 1 km buffer around each participant's residential address. Logistic regression models examined the associations between environmental exposures and COPD prevalence adjusting for a range of confounders. Subgroup analyses by urbanicity and effect modification by white blood cell count as an inflammatory marker were also done. FindingsWe assessed 96 779 participants recruited between April 4, 2006, and Oct 1, 2010, of which 5391 participants had COPD with a prevalence of 5·6%. Each 10 µg/m³ increment in ambient PM 2·5 exposure at a participant's residential location was associated with higher odds of COPD (odds ratio 1·55, 95% CI 1·14-2·10). Among the built environment metrics, urbanicity was associated with higher odds of COPD (1·05, 1·01-1·08 per interquartile increment), whereas residential greenness was protective, being associated with lower odds of COPD (0·89, 0·84-0·93 for each interquartile increment in greenness). The results remained consistent in models of COPD defined as per lower limit of normal criteria. The highest quartile of white blood cell count was associated with lower lung function and higher COPD risk with a significant interaction between PM 2·5 and white blood cell count only in the model of lung function (p=0·0003).Interpretation In this study of the built environment and COPD, to our knowledge the largest done in the UK, we found that exposure to ambient PM 2·5 and urbanicity were associated with a higher risk of COPD. Residing in greener areas, as measured by normalised difference vegetation index, was associated with lower odds of COPD, suggesting the potential value of urban planning and design in minimising or offsetting environmental risks for the prevention and management of COPD.

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Projecting the COPD population and costs in England and Scotland: 2011 to 2030

Cited by 61 publications

References 22 publications

Are COPD self-management mobile applications effective? A systematic review and meta-analysis

Are COPD self-management mobile applications effective? A systematic review and meta-analysis

Temporal trends in survival following ward‐based NIV for acute hypercapnic respiratory failure in patients with COPD

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

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