Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data
Abstract Background Chronic obstructive pulmonary disease (COPD) represents an important health challenge, despite being preventable and manageable thanks to up-to-date recommendations. In Italy, the pharmaceutical care of COPD patients is still ill-timed and inaccurate. This study aimed to describe...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-10-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-024-03339-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846112901445713920 |
|---|---|
| author | Letizia Dondi Giulia Ronconi Silvia Calabria Irene Dell’Anno Leonardo Dondi Carlo Piccinni Ovidio Brignoli Giorgio Walter Canonica Mauro Carone Fabiano Di Marco Claudio Micheletto Carlo Vancheri Antonella Pedrini Alice Addesi Immacolata Esposito Nello Martini |
| author_facet | Letizia Dondi Giulia Ronconi Silvia Calabria Irene Dell’Anno Leonardo Dondi Carlo Piccinni Ovidio Brignoli Giorgio Walter Canonica Mauro Carone Fabiano Di Marco Claudio Micheletto Carlo Vancheri Antonella Pedrini Alice Addesi Immacolata Esposito Nello Martini |
| author_sort | Letizia Dondi |
| collection | DOAJ |
| description | Abstract Background Chronic obstructive pulmonary disease (COPD) represents an important health challenge, despite being preventable and manageable thanks to up-to-date recommendations. In Italy, the pharmaceutical care of COPD patients is still ill-timed and inaccurate. This study aimed to describe the treatment of COPD patients in Italy and possible switches following an exacerbation. Methods This observational retrospective analysis of Italian administrative healthcare data from the Fondazione Ricerca e Salute (ReS) database identified patients aged ≥ 45 years with COPD in 2019 and 2020. At least 6 years of look-back period and absence of concomitant asthma were required. COPD patients were categorized by treatment (SI–single/MI–multiple inhalers, TT–triple therapy, DT–dual therapy, other respiratory treatments, untreated) at index date (first dispensation during accrual period). Occurrence of moderate/severe exacerbation during one-year preceding index date and treatments during one-year preceding the exacerbation (possible switch) were evaluated. Results From ~ 4.7 million beneficiaries of the Italian National Health Service in 2019 and 2020, respectively, 105,828 and 103,729 (43 and 41 × 1,000 inhabitants aged ≥ 45 years) were identified as having COPD. Of 2019/2020 patients: 3.4%/5.2% received SI-TT, 20.7%/17.5% MI-TT, 35.9%/38.1% DT, 33.0%/33.1% other treatments, and 7.0%/6.0% were untreated. Males were prevalent and median age was > 73 years for all groups. Of 2019/2020 cohorts, heart failure and coronary artery disease affected 24/20%, 18/17%, and 11%/16% patients with SI-TT, MI-TT, DT, and other treatments, respectively. A previous moderate/severe exacerbation (2019/2020 patients) occurred to 60.5%/56.6%, 39.9%/37.4%, 30.8%/29.2% and 31.9%/29.7% patients treated with SI-TT, MI-TT, DT, and other treatments, respectively. Of 2019/2020 patients experiencing moderate/severe exacerbation: 6.0%/7.0% receiving DT, 5.1%/7.0% receiving other treatments and 4.5%/10.0% untreated, switched to SI-TT; 23.7%/16.9% receiving DT, 21.4%/17.7% receiving other treatments and 15.4%/12.0% untreated, switched to MI-TT. Conclusions COPD patients receiving TT were older and had more comorbidities, especially cardiovascular diseases, than patients receiving DT or other treatments. The limited number of patients switching after exacerbation suggests that many COPD patients may be inappropriately treated. Ensuring early and adequate treatment, combination of in-hospital and outpatient management, and integration of specialist and primary care is pivotal for the appropriate clinical management of COPD patients. |
| format | Article |
| id | doaj-art-15e8cbd5aa1f4ebbb47e07f15c752dd8 |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-15e8cbd5aa1f4ebbb47e07f15c752dd82024-12-22T12:11:33ZengBMCBMC Pulmonary Medicine1471-24662024-10-0124111010.1186/s12890-024-03339-5Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare dataLetizia Dondi0Giulia Ronconi1Silvia Calabria2Irene Dell’Anno3Leonardo Dondi4Carlo Piccinni5Ovidio Brignoli6Giorgio Walter Canonica7Mauro Carone8Fabiano Di Marco9Claudio Micheletto10Carlo Vancheri11Antonella Pedrini12Alice Addesi13Immacolata Esposito14Nello Martini15Fondazione Ricerca e Salute (ReS) – Research and Health FoundationFondazione Ricerca e Salute (ReS) – Research and Health FoundationFondazione Ricerca e Salute (ReS) – Research and Health FoundationFondazione Ricerca e Salute (ReS) – Research and Health FoundationFondazione Ricerca e Salute (ReS) – Research and Health FoundationFondazione Ricerca e Salute (ReS) – Research and Health FoundationItalian College of General Practitioners and Primary CareDepartment of Biomedical Sciences, Humanitas UniversityIstituti Clinici Scientifici Maugeri IRCCSUniversità Degli Studi Di MilanoVerona University HospitalCatania University HospitalFondazione Ricerca e Salute (ReS) – Research and Health FoundationDrugs & Health SrlDrugs & Health SrlFondazione Ricerca e Salute (ReS) – Research and Health FoundationAbstract Background Chronic obstructive pulmonary disease (COPD) represents an important health challenge, despite being preventable and manageable thanks to up-to-date recommendations. In Italy, the pharmaceutical care of COPD patients is still ill-timed and inaccurate. This study aimed to describe the treatment of COPD patients in Italy and possible switches following an exacerbation. Methods This observational retrospective analysis of Italian administrative healthcare data from the Fondazione Ricerca e Salute (ReS) database identified patients aged ≥ 45 years with COPD in 2019 and 2020. At least 6 years of look-back period and absence of concomitant asthma were required. COPD patients were categorized by treatment (SI–single/MI–multiple inhalers, TT–triple therapy, DT–dual therapy, other respiratory treatments, untreated) at index date (first dispensation during accrual period). Occurrence of moderate/severe exacerbation during one-year preceding index date and treatments during one-year preceding the exacerbation (possible switch) were evaluated. Results From ~ 4.7 million beneficiaries of the Italian National Health Service in 2019 and 2020, respectively, 105,828 and 103,729 (43 and 41 × 1,000 inhabitants aged ≥ 45 years) were identified as having COPD. Of 2019/2020 patients: 3.4%/5.2% received SI-TT, 20.7%/17.5% MI-TT, 35.9%/38.1% DT, 33.0%/33.1% other treatments, and 7.0%/6.0% were untreated. Males were prevalent and median age was > 73 years for all groups. Of 2019/2020 cohorts, heart failure and coronary artery disease affected 24/20%, 18/17%, and 11%/16% patients with SI-TT, MI-TT, DT, and other treatments, respectively. A previous moderate/severe exacerbation (2019/2020 patients) occurred to 60.5%/56.6%, 39.9%/37.4%, 30.8%/29.2% and 31.9%/29.7% patients treated with SI-TT, MI-TT, DT, and other treatments, respectively. Of 2019/2020 patients experiencing moderate/severe exacerbation: 6.0%/7.0% receiving DT, 5.1%/7.0% receiving other treatments and 4.5%/10.0% untreated, switched to SI-TT; 23.7%/16.9% receiving DT, 21.4%/17.7% receiving other treatments and 15.4%/12.0% untreated, switched to MI-TT. Conclusions COPD patients receiving TT were older and had more comorbidities, especially cardiovascular diseases, than patients receiving DT or other treatments. The limited number of patients switching after exacerbation suggests that many COPD patients may be inappropriately treated. Ensuring early and adequate treatment, combination of in-hospital and outpatient management, and integration of specialist and primary care is pivotal for the appropriate clinical management of COPD patients.https://doi.org/10.1186/s12890-024-03339-5Retrospective studiesChronic Obstructive Pulmonary DiseaseCardiovascular DiseasesDisease ExacerbationPharmaceutical ServicesDelivery of Health Care |
| spellingShingle | Letizia Dondi Giulia Ronconi Silvia Calabria Irene Dell’Anno Leonardo Dondi Carlo Piccinni Ovidio Brignoli Giorgio Walter Canonica Mauro Carone Fabiano Di Marco Claudio Micheletto Carlo Vancheri Antonella Pedrini Alice Addesi Immacolata Esposito Nello Martini Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data BMC Pulmonary Medicine Retrospective studies Chronic Obstructive Pulmonary Disease Cardiovascular Diseases Disease Exacerbation Pharmaceutical Services Delivery of Health Care |
| title | Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data |
| title_full | Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data |
| title_fullStr | Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data |
| title_full_unstemmed | Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data |
| title_short | Clinical characteristics, use and switch of drugs for obstructive airway diseases among patients with COPD experiencing an exacerbation: a retrospective analysis of Italian administrative healthcare data |
| title_sort | clinical characteristics use and switch of drugs for obstructive airway diseases among patients with copd experiencing an exacerbation a retrospective analysis of italian administrative healthcare data |
| topic | Retrospective studies Chronic Obstructive Pulmonary Disease Cardiovascular Diseases Disease Exacerbation Pharmaceutical Services Delivery of Health Care |
| url | https://doi.org/10.1186/s12890-024-03339-5 |
| work_keys_str_mv | AT letiziadondi clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT giuliaronconi clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT silviacalabria clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT irenedellanno clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT leonardodondi clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT carlopiccinni clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT ovidiobrignoli clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT giorgiowaltercanonica clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT maurocarone clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT fabianodimarco clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT claudiomicheletto clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT carlovancheri clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT antonellapedrini clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT aliceaddesi clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT immacolataesposito clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata AT nellomartini clinicalcharacteristicsuseandswitchofdrugsforobstructiveairwaydiseasesamongpatientswithcopdexperiencinganexacerbationaretrospectiveanalysisofitalianadministrativehealthcaredata |