Asthma and Chronic Obstructive Pulmonary Disease Overlap Syndrome: Doubled Costs Compared with Patients with Asthma Alone

Verdier, Maria Gerhardsson de; Andersson, Maria; Kern, David M.; Zhou, Siting; Tunceli, Ozgur

doi:10.1016/j.jval.2015.04.010

Cited by 40 publications

(23 citation statements)

References 22 publications

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“…Our findings of a greater comorbidity burden, medication use, and costs in the claims-positive ACO cohort compared with the claims-positive asthma and COPD cohorts were consistent with prior studies [18]. However, the lower costs observed in the confirmed ACO cohort differed from prior studies that showed ACO patients with higher resource utilization and costs [18,33-35].…”

Section: Discussionsupporting

confidence: 87%

“…The literature suggests that, compared with asthma or COPD, ACO is associated with more rapid decline in lung function, more frequent exacerbations, increased health care resource utilization, worsening quality of life, and higher mortality rates [16,18,19]. This profile, however, relies on diversely defined populations and prevalence estimates [15,17,20] and might have dubious diagnostic utility.…”

Section: Introductionmentioning

confidence: 99%

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Overlap of Asthma and Chronic Obstructive Pulmonary Disease in Patients in the United States: Analysis of Prevalence, Features, and Subtypes

Turner¹,

DePietro²,

Ding³

2018

JMIR Public Health Surveill

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BackgroundAlthough asthma and chronic obstructive pulmonary disease (COPD) are clinically distinct diseases, they represent biologically diverse and overlapping clinical entities and it has been observed that they often co-occur. Some research and theorizing suggest there is a common comorbid condition termed asthma-chronic obstructive pulmonary disease overlap (ACO). However, the existence of ACO is controversial.ObjectiveThe objective of this study is to describe patient characteristics and estimate prevalence, health care utilization, and costs of ACO using claims-based diagnoses confirmed with medical record information.MethodsEligible patients were commercial US health plan enrollees; ≥40 years; had asthma, COPD, or ACO; ≥3 prescription fills for asthma/COPD medications; and ≥2 spirometry tests. Records for a random sample of 5000 patients with ACO were reviewed to validate claims-based diagnoses.ResultsThe estimated ACO prevalence was 6% (estimated 10,250/183,521) among 183,521 full study patients. In the claims-based cohorts, the comorbidity burden for ACO was greater versus asthma but similar to COPD cohorts. Medication utilization was higher in ACO versus asthma and COPD. Mean total health care costs were significantly higher for ACO versus asthma but similar to COPD. In confirmed diagnoses cohorts, mean total health care costs (medical plus pharmacy) were lower for ACO versus COPD but similar to asthma (US $20,035; P=.56). Among confirmed cases, where there was medical record evidence, smoking history was higher in ACO (300/343, 87.5%) versus asthma cohorts (100/181, 55.2%) but similar to COPD (68/84, 81%).ConclusionsACO had more comorbidities, medication utilization, and costs than patients with asthma or COPD but differences were not seen after confirmation with medical records.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Overlap of Asthma and Chronic Obstructive Pulmonary Disease in Patients in the United States: Analysis of Prevalence, Features, and Subtypes

Turner¹,

DePietro²,

Ding³

2018

JMIR Public Health Surveill

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“…The frequency of emergency room visits and intensive care unit admissions are higher among those patients with overlap syndrome compared to those with COPD but not asthma [12]. In addition, overall healthcare expenditure for patients with co-existent asthma and COPD is almost twice the expenditure for patients with asthma but not COPD [13].…”

Section: Reviewmentioning

confidence: 99%

Ashtma-Chronic obstructive pulmonary disease overlap syndrome (ACOS): current evidence and future research directions

et al. 2017

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Chronic obstructive pulmonary disease and asthma are the most frequent chronic respiratory diseases that affect the general population. For a long period of time these two conditions were considered to be separate diseases. However, it became evident that some patients share symptoms and clinical findings from both diseases. These patients are considered to represent a distinct phenotype, called asthma-COPD overlap syndrome (ACOS). However, since approximately the one third of the asthmatics smoke the ACOS may primarily define those patients. This is a relatively newly defined clinical syndrome whose underlying mechanisms and most appropriate management remain to be confirmed. In this review, we summarize current knowledge on this syndrome, aiming to update clinicians and help their daily practice.

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“…2012-ben került publikálásra a spanyol konszenzusdokumentum az ACOS COPD-ben való szerepéről [13], illetve a 2015-ben publikált GINA (Global Initiative for Asthma) és GOLD (Global Initiative for Chronic Obstructive Lung Disease) dokumentumok is már tartalmaznak ajánláso-kat ezeknek a betegeknek az azonosításához [14]. További nem elhanyagolható szempont, hogy a betegség-hez kapcsolódó egészségügyi kiadások közel kétszer olyan magasak az ACOS-betegek esetében, mint az asthma vagy COPD önálló fennállása esetén [15,16]. Az 1. táblázatban foglaltuk össze azokat a kérdéseket, amelyek az ACOS fontosságának aktualitását mutatják meg.…”

Section: öSszefoglaló Közleményunclassified

“…A dokumentum kitér arra is, hogy a specifikus definícióhoz még további vizsgálatok szükségesek a kü-lönféle fenotípusok pontos meghatározásával. A légúti obstrukció igazolása után asthma, COPD, valamint való-színű asthma és valószínű COPD csoportok mellett lehet az ACOS klinikai diagnózisát felállítani [15].…”

Section: Definíció éS Diagnosztikai Megfontolásokunclassified

Asthma-COPD overlap szindróma

Odler

Müller

2016

Orvosi Hetilap

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Az obstruktív tüdőbetegségek világszerte jelentős népegészségügyi problémát jelentenek, magas prevalenciájuk és a társadalmat érintő nagy szocioökonómiai költségeik miatt. Az asthma bronchiale és a krónikus obstruktív tüdőbeteg-ség krónikus légúti gyulladással járó betegségek, amelyeket légúti obstrukció jellemez, azonban külön nozológiai entitások, figyelembe véve kialakulásukat, diagnosztikájukat, a terápiás megfontolásokat és prognosztikai jellemzői-ket. A két betegség együttesen is előfordulhat, vagy az egyik állapot képes a másik jellemzőit felvéve, abba átalakulni. Ezt a kevert asthma-COPD fenotípust nevezzük asthma-COPD overlap szindrómának, amelyet úgy jellemeznek, hogy olyan perzisztáló légúti áramláskorlátozottsággal járó betegség, amely rendelkezik mind az asthma, mind a krónikus obstruktív tüdőbetegség egyes jellemzőivel. A szindróma az elmúlt években jelentős figyelmet kapott, azonban a betegek nagy része mostanáig kizárásra került a klinikai és légúti gyógyszer-hatásossági vizsgálatokból, így a jól meghatározott klinikai jellemzők és a megfelelő terápia továbbra sem ismertek. Az összefoglaló közlemény elsődleges célja az elmúlt években leírt patofiziológiai és klinikai jellemzők, terápiás megfontolások és irodalmi újdonságok bemutatása. Orv. Hetil., 2016, 157(33), 1304-1313. Kulcsszavak: ACOS overlap szindróma, COPD, asthma bronchiale, obstruktív, terápia Asthma-COPD overlap syndromeObstructive lung diseases represent a major health problem worldwide due to their high prevalence associated with elevated socioeconomic costs. Bronchial asthma and chronic obstructive pulmonary disease are chronic obstructive ventilatory disorders with airway inflammation, however they are separate nosological entities based on thedifferent development, diagnostic and therapeutic approaches, and prognostic features. However, these diseases may coexist and can be defined as the coexistence of increased variability of airflow in a patient with incompletely reversible airway obstruction. This phenotype is called asthma -chronic obstructive pulmonary disease overlap syndrome. The syndrome is a clinical and scientific challenge as the majority of these patients have been excluded from the clinical and pharmacological trials, thus well-defined clinical characteristics and therapeutic approaches are lacking. The aim of this review is to summarize the currently available literature focusing on pathophysiological and clinical features, and discuss possible therapeutic approaches of patients with asthma -chronic obstructive pulmonary disease overlap syndrome. -nél kisebb erek átmérőjének százalékos ará-nya; AA = afroamerikai; ACOS = asthma-COPD overlap szindróma; ACT = asthmakontrollteszt; BHR = fokozott válaszadó készség; BMI = testtömegindex; BODE-index = body mass index (testtömegindex), airflow obstruction (légúti obstrukció), dyspnea and exercise capacity (légszomj és terhelési kapacitás); BOLD = Burden of Obstructive Lung Diseases; CAT = COPD Assessment Test; COPD = krónikus obstruktív tüdőbe-tegség; CRP = C reaktív protei...

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Asthma and Chronic Obstructive Pulmonary Disease Overlap Syndrome: Doubled Costs Compared with Patients with Asthma Alone

Abstract: Patients with asthma and COPD had nearly double the health care costs as did patients with asthma without COPD. The overall disease profile of patients with asthma should be considered when managing patients, rather than treating asthma as a solitary condition.

Cited by 40 publications

References 22 publications

Overlap of Asthma and Chronic Obstructive Pulmonary Disease in Patients in the United States: Analysis of Prevalence, Features, and Subtypes

Overlap of Asthma and Chronic Obstructive Pulmonary Disease in Patients in the United States: Analysis of Prevalence, Features, and Subtypes

Ashtma-Chronic obstructive pulmonary disease overlap syndrome (ACOS): current evidence and future research directions

Asthma-COPD overlap szindróma

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