The burden of COPD in the U.K.: results from the confronting COPD survey

Abstract

Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airflow limitation and decline in lung function. As seen in other developed countries throughout the world, COPD in the U.K is associated with considerable mortality, and morbidity from the disease places a significant burden on the healthcare system and society. Despite the obvious burden of COPD in this country, there is a lack of recognition of COPD among the general public. Healthcare professionals may also fail to recognize the burden of disease, as shown by underdiagnosis and inadequate managemen. A key step in increasing awareness of the burden of COPD is obtaining comprehensive information about the impact of the disease on patients, the health service and society. The large-scale international survey, Confronting COPD in North America and Europe, aimed to address this need for information, by interviewing patients and physicians in eight countries. An economic analysis of patient responses to the survey in the U.K showed that COPD places a high burden on the healthcare system and society with annual direct costs estimated at pounds 819.42 per patient, and indirect cost at pound 819.66 per patient resulting in total per patient costs of pound 1639.08. The cost impact of the disease was particularly marked in secondary care, as a result of inpatient hospitalizations, amounting to 54% of direct costs. These results suggest that reducing patient requirement for hospital care could alleviate the burden of COPD on the U.K. healthcare system. This will require considerable improvements to the way the disease is managed by healthcare professionals in primary care, with earlier diagnosis and the use of interventions aimed at preventing exacerbations and delaying the progression of disease.

Nicotine preloading for smoking cessation: the Preloading RCT

“…Costs relate to prevalent cases of disease. The annual cost for COPD is £1042.57, for lung cancer is £7002.65, for CHD is £1247.79 and for stroke is £5886.66 [79][80][81][82] (see Appendix 1, Table 36). …”

Trends in the epidemiology of chronic obstructive pulmonary disease in England: a national study of 51 804 patients

“…23 Mean consultation rates (7.9 per year) were higher than those from a survey conducted in 2002 of 500 patients throughout the UK with COPD (6.6 visits per year), although this was a telephone survey that relied on patient recollection and may have been affected by recall bias. 24 …”

Bisoprolol in COPD study

“…Exacerbations are associated with accelerated rate of lung function decline [14], reduced physical activity [15], reduced quality of life [16], increased mortality [17] and increased risk of comorbidities such as acute myocardial infarction and stroke [18]. It has been estimated that exacerbations account for about 60% of the £1billion NHS expenditure on COPD [19]. Emergency hospital admissions for exacerbations of COPD have steadily increased as a percentage of all admissions from 0.5% in 1991 to 1% in 2000 to 1.5% in 2008/9 [20].…”