Real-world retrospective cohort study ARCTIC shows burden of comorbidities in Swedish COPD versus non-COPD patients

Abstract

This study aimed to generate real-world evidence to assess the burden of comorbidities in COPD patients, to effectively manage these patients and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients using electronic medical record data collected between 2000 and 2014. These patients were studied for prevalence of various comorbidities and for association of these comorbidities with exacerbations, mortality, and healthcare costs compared with an age-, sex-, and comorbidities-matched non-COPD reference population. A total of 17,479 patients with COPD were compared with 84,514 non-COPD reference population. A significantly higher prevalence of various comorbidities was observed in COPD patients 2 years post-diagnosis vs. reference population, with the highest percentage increase observed for cardiovascular diseases (81.8% vs. 30.7%). Among the selected comorbidities, lung cancer was relatively more prevalent in COPD patients vs. reference population (relative risk, RR = 5.97, p < 0.0001). Ischemic heart disease, hypertension, depression, anxiety, sleep disorders, osteoporosis, osteoarthritis, and asthma caused increased mortality rates in COPD patients. Comorbidities that were observed to be significantly associated with increased number of severe exacerbations in COPD patients included heart failure, ischemic heart disease, depression/anxiety, sleep disorders, osteoporosis, lung cancer, and stroke. The cumulative healthcare costs associated with comorbidities over 2 years after the index date were observed to be significantly higher in COPD patients (€27,692) vs. reference population (€5141) (p < 0.0001). The data support the need for patient-centered treatment strategies and targeted healthcare resource allocation to reduce the humanistic and economic burden associated with COPD comorbidities.

<p>Impact of Comorbidities and Commonly Used Drugs on Mortality in COPD – Real-World Data from a Primary Care Setting</p>

“…Several of the negative prognostic factors identified in our study, including age, male gender, exacerbations and comorbidities such as heart disease, stroke, diabetes, fractures and the Charlson comorbidity index score, are known from previous work. [4][5][6][7][43][44][45] The positive prognostic factors reported here (higher education and income) are also in line with previous studies. 46 Our results confirm the prognostic value of the above-mentioned factors also in the real-world primary care setting.…”

“…2 Comorbidities influence morbidity and mortality in COPD, 3 as exemplified by the increased mortality risk associated with cardiovascular disease (CVD), lung cancer, diabetes and depression or anxiety, among others. [4][5][6][7] The more comorbidities a COPD patient has, the higher is the risk of early death.…”

“…15 Currently, most of the knowledge of factors influencing COPD mortality has been acquired from RCTs with a highly select study-population or studies made in secondary care settings, [4][5][6]16 indicating populations with more severe COPD. There are only limited data from realworld primary care COPD cohorts on the effect of comorbidities on mortality, 7,17 and to our knowledge no such studies examining the effect of drug-use on mortality. The aim of this observational, retrospective study was to increase our knowledge on the influence of comorbidities and pharmacological treatment on COPD mortality, by combining data from electronic patient records with data from Swedish national registers on a large real-world cohort of primary care COPD patients.…”

Developing a strategic understanding of telehealth service adoption for COPD care management: A causal loop analysis of healthcare professionals

“…Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease of which the prevalence continues to rise worldwide [1]. This implies an increasing demand for healthcare services [2,3], especially for the management of the highly comorbid [4] and elderly [5] COPD patients. Early recognition of COPD exacerbation or self-management education are some of the examples for services, which are given too little attention in healthcare organizations providing care to COPD patients [6].…”

Improved quality of care by using the PRISMS form to support self‐management in patients with COPD: A Randomised Controlled Trial

“…COPD is at most a smoking‐induced public health burden, complicated by severe comorbidities and increased mortality (GOLD, 2019). COPD is associated with many comorbidities, such as cardiovascular diseases, stroke, diabetes, depression and anxiety, as well as an increased risk of malignancy, especially lung cancer (van der Molen, 2010; Ställberg et al, 2018). Patients with COPD experience many symptoms that affect their everyday lives, such as shortness of breath, cough, lack of energy, dry mouth, numbness or tingling in hands and feet, pain, and sleeping problems (Theander et al, 2014).…”