title: Utilization of health care services by patients with chronic obstructive pulmonary disease.
abstract: In order to identify healthcare resource use patterns associated with chronic obstructive pulmonary disease (COPD), resource utilization (RU) data collection was integrated into a randomized, double-blind placebo-controlled study of Viozan (sibenadet HCl). This study enrolled patients with symptomatic, smoking-related COPD, randomized to receive sibenadet or placebo for a 52-week treatment period. A questionnaire establishing typical pre-trial, COPD-related RU was completed by each patient. Subsequent data were collected by means of an Interactive Voice Response System (IVRS) at 30-day intervals (14 time points) during the study and in the follow-up period. The IVRS system facilitated data collection and minimized inconvenience to the patient. Compliance with the requirement to record details of the healthcare services during the year-long study was high. No overall trend for lower RU was associated with sibenadet therapy, which correlates with the lack of sustained clinical effect seen in studies conducted concurrently. These data do, however, provide valuable information on RU associated with COPD and insights into adjustments associated with changes in disease course. Physicians were seen to be the most common source of care for patients with COPD and more of the patients with severe COPD (stage III) than mild (stage I) were seen to utilize the most expensive resources (e.g. inpatient hospital care). For those patients who experienced an exacerbation during the trial (irrespective of treatment group), resource use was increased during the periods when an exacerbation was reported when compared with the periods before or after an exacerbation. The proportion of cases attending the physician doubled and with a trip to the Emergency Room (ER) increased approximately ninefold during the reporting period in which the exacerbation occurred compared with the previous month. This study has shown that use of an IVRS, even in elderly patients, is an effective means of gathering RU data over long periods. The study findings suggest that the advent of effective therapeutic interventions, particularly any with the ability to minimize exacerbations and limit disease progression, could impact on the health care services used and potentially reduce associated costs.
authors.affiliation: Caro Research Institute, Concord, MA 01742, USA. jobrien@caroresearch.com
authors.forename: J A
authors.initials: JA
authors.lastname: O'Brien
authors.forename: A J
authors.initials: AJ
authors.lastname: Ward
authors.forename: M K C
authors.initials: MK
authors.lastname: Jones
authors.forename: C
authors.initials: C
authors.lastname: McMillan
authors.forename: N
authors.initials: N
authors.lastname: Lordan
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists; D000328:Adult; D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D018343:Receptors, Adrenergic, beta-2 / Q000627:therapeutic use; D017448:Receptors, Dopamine D2 / Q000819:agonists / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018343:Receptors, Adrenergic, beta-2; D017448:Receptors, Dopamine D2; D013844:Thiazoles; C116267:sibenadet