Non-adherence to COPD medications and its association with adverse events: A longitudinal population based cohort study of older adults

Weir, Daniala L.; Bai, Yu Qing; Thavorn, Kednapa; Guilcher, Sara; Kanji, Salmaan; Mulpuru, Sunita; Wodchis, Walter

doi:10.1016/j.annepidem.2023.12.003

Annals of Epidemiology

2024

DOI: 10.1016/j.annepidem.2023.12.003

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Non-adherence to COPD medications and its association with adverse events: A longitudinal population based cohort study of older adults

Daniala L. Weir,

Yu Qing Bai,

Kednapa Thavorn

et al.

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2024

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Cited by 3 publications

References 38 publications

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Medication adherence halves COPD patients’ hospitalization risk – evidence from Swiss health insurance data

Bischof,

Cordier,

Vogel

et al. 2024

npj Prim. Care Respir. Med.

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Medication adherence is vital for patients suffering from Chronic Obstructive Pulmonary Disease (COPD) to mitigate long-term consequences. The impact of poor medication adherence on inferior outcomes like exacerbations leading to hospital admissions is yet to be studied using real-world data. Using Swiss claims data from 2015-2020, we group patients into five categories according to their medication possession ratio. By employing a logistic regression, we quantify each category’s average treatment effect of the medication possession ratio on hospitalized exacerbations. 13,557 COPD patients are included in the analysis. Patients with high medication adherence (daily medication reserve of 80% to 100%) are 51% less likely to incur exacerbation following a hospital stay than patients with the lowest medication adherence (daily medication reserve of 0% to 20%). The study shows that medication adherence varies strongly among Swiss COPD patients. Furthermore, high medication adherence immensely decreases the risk of hospitalized exacerbations.

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Medication adherence halves COPD patients’ hospitalization risk – evidence from Swiss health insurance data

Bischof,

Cordier,

Vogel

et al. 2024

npj Prim. Care Respir. Med.

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Factors Affecting Mortality and Distribution of Co-morbidities in Chronic Obstructive Pulmonary Disease

Kim

2024

J Health Info Stat

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Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. This study aims to identify the rules associated with major comorbidities in patients with COPD and analyze how they affect death, thereby suggesting patient management measures that are efficient and can improve the quality of medical care.Methods: For this purpose, among the Korea Disease Control and Prevention Agency’s discharge injury in-depth survey data of more than 3 million cases from 2006 to 2021, adult patients aged 19 years or older with a principal diagnosis of chronic obstructive pulmonary disease were targeted. <i>χ</i><sup>2</sup>-test and independent sample t-test were performed to analyze the distribution of deaths by demographic characteristics, and ARM (Association Rule Mining) was analyzed for association rules for comorbidities. Logistic regression analysis was performed on factors influencing death.Results: As a result of the analysis, the mortality rate was high in patients over 75 years of age, patients admitted to the emergency room, and patients discharged from medical institutions with more than 1,000 beds. The prevalence of comorbidities was high for E11 (Type 2 diabetes mellitus) and I10 (essential hypertension). As a result of analyzing the impact on death based on major association rules, other sepsis (A41) and essential hypertension (I10), other sepsis (A41) and pneumonia, organism unspecified (J18), sequelae of tuberculosis (B90) and J96 (respiratory Failure, NEC), sequelae of tuberculosis (B90), and I27 (other pulmonary heart diseases) were found to have a high probability of death.Conclusions: Based on the major association rules affecting death, we propose to apply them to a clinical decision support system for efficient patient management and personalized treatment.

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Policy predictive model for better management of chronic obstructive pulmonary disease: economic-organisational implications in the Italian healthcare system

Antonini,

De Michele,

Micheletto

et al. 2024

Grhta

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Background: Chronic obstructive pulmonary disease (COPD) represents a significant public health problem in Italy, with a high prevalence and a substantial economic burden on the National Health Service (NHS). Effective management of the disease is crucial for reducing exacerbations and improving patients’ quality of life. Methods: This study employs a dynamic predictive model to assess the economic impact of implementing three specific health policies aimed at improving COPD management over a five-year horizon. The analysis is conducted from the perspective of the NHS, focusing on the direct costs associated with disease management. Results: The implementation of the proposed policies demonstrated potential significant savings in direct healthcare costs. The first policy, focused on increasing therapeutic adherence, generated an estimated savings of 202 million €. The second, concerning the wider use of triple therapies, led to savings of about 142 million €. Finally, the third policy, aimed at reducing the delay in prescribing appropriate therapies, contributed to an additional saving of over 175 million € in the time horizon considered in the analysis. Overall, these results suggest a substantial improvement opportunity in COPD management, with significant economic benefits for the Italian NHS. Conclusion: The study confirms the importance of targeted policies in the management of COPD, highlighting how strategic interventions can lead to significant resource savings while simultaneously improving patient care. These results provide a solid foundation for further research and serve as a useful guide for decision-makers in planning effective intervention strategies, aimed at optimizing resources and enhancing disease management in the Italian healthcare context.

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Non-adherence to COPD medications and its association with adverse events: A longitudinal population based cohort study of older adults

Cited by 3 publications

References 38 publications

Medication adherence halves COPD patients’ hospitalization risk – evidence from Swiss health insurance data

Medication adherence halves COPD patients’ hospitalization risk – evidence from Swiss health insurance data

Factors Affecting Mortality and Distribution of Co-morbidities in Chronic Obstructive Pulmonary Disease

Policy predictive model for better management of chronic obstructive pulmonary disease: economic-organisational implications in the Italian healthcare system

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