Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Improvement in COPD management by access to asthma/COPD clinics in primary care: Data from the observational PATHOS study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Show others and affiliations
2014 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 108, no 9, 1345-1354 p.Article in journal (Refereed) Published
Abstract [en]

Background: Chronic obstructive pulmonary disease (COPD) guidelines emphasize the importance of patient education to improve quality of life and avoid exacerbations. Longitudinal evaluations of structured management of COPD in primary care are lacking. Aim: To evaluate the impact of primary care asthma/COPD clinics on exacerbations, hospitalizations, and associated costs in COPD. Methods: This population-based, retrospective, observational study, linking primary care medical records data to mandatory Swedish national registries, included patients with COPD from 76 primary healthcare centers (1999-2009). A questionnaire on access to an asthma/COPD clinic was retrospectively answered. Propensity score matching was performed at index (COPD diagnosis) by center type (with and without an asthma/COPD clinic). Poisson regression was used to compare the yearly rate of exacerbations (hospitalization, emergency visits, or prescription for oral steroids or antibiotics) and COPD-related prescriptions at the centers. An economic analysis was performed from the Swedish healthcare perspective using 2011 unit costs and the incremental cost-effectiveness ratio was calculated. Results: The study included 21,361 patients (mean age, 68.0 years; 53% female). Access to asthma/COPD clinics increased from 34% to 85% during the study period. Patients at primary healthcare centers with asthma/COPD clinics had 27% fewer exacerbations (0.71 vs. 0.98) and 37% fewer hospitalizations annually (0.36 vs. 0.58) (p < 0.0001). Asthma/COPD clinics reduced the annual cost of medication and healthcare contacts by 37% (SEK 52,892 [(sic)5858] to SEK 33,410 [(sic)3700] per patient). Conclusions: Patients at primary healthcare centers with asthma/COPD clinics experienced fewer COPD exacerbations and hospitalizations, and overall treatment costs were substantially reduced. ClinicalTrials.gov identifier: NCT01146392. (C) 2014 The Authors. Published by Elsevier Ltd.

Place, publisher, year, edition, pages
2014. Vol. 108, no 9, 1345-1354 p.
Keyword [en]
COPD, Asthma/COPD clinic, Exacerbations, Cost-effectiveness analysis, Healthcare costs
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-236094DOI: 10.1016/j.rmed.2014.06.002ISI: 000342879200013OAI: oai:DiVA.org:uu-236094DiVA: diva2:763401
Available from: 2014-11-14 Created: 2014-11-12 Last updated: 2017-12-05Bibliographically approved

Open Access in DiVA

fulltext(597 kB)220 downloads
File information
File name FULLTEXT01.pdfFile size 597 kBChecksum SHA-512
9168dbdbdda703fea4cb2e1c0b3bda3d7ee5d367c3bd2350236d4141bc010cb59779ebac299bcf84d57751059a1a95ae513c455f2dee797268602ade6af15ea7
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Authority records BETA

Lisspers, KarinJohansson, GunnarJansson, ChristerStällberg, Björn

Search in DiVA

By author/editor
Lisspers, KarinJohansson, GunnarJansson, ChristerStällberg, Björn
By organisation
Family Medicine and Preventive MedicineRespiratory Medicine and Allergology
In the same journal
Respiratory Medicine
Respiratory Medicine and Allergy

Search outside of DiVA

GoogleGoogle Scholar
Total: 220 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 440 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf