beta-Blocker therapy in veterans with asthma or chronic obstructive pulmonary disease.
OBJECTIVE
To determine whether an association exists between health care resource use and beta-blocker therapy in patients with asthma or chronic obstructive pulmonary disease (COPD), and to determine whether any significant differences exist between type of beta-blocker agent administered and resource use.


METHODS
Retrospective cohort study.


METHODS
Three Veterans Administration (VA) databases with information from hospitals and clinics in Iowa and Nebraska. Patients. A total of 8390 veterans with a diagnosis of asthma or COPD receiving treatment with a beta-blocker or another cardiovascular agent.


RESULTS
Clinic visits and hospital admissions for asthma or COPD that occurred in 2000-2001 were identified using electronic administrative data files. Analyses were adjusted for comorbidity and patient demographics. Mean patient age was 67 years, and 97% of the patients were men. In unadjusted analyses, patients taking beta-blockers had more hospital admissions, similar inpatient length of stay (LOS), and fewer outpatient clinic visits for asthma or COPD. In adjusted analyses, however, no difference was noted in the odds of hospital admission or in LOS, and patients had fewer clinic visits related to asthma or COPD. The hazard ratio for hospital admission for asthma or COPD during the observation year was similar for patients taking and not taking beta-blockers, and no difference was noted with selective versus nonselective beta-blockers. However, the hospital admission rate was lower with atenolol than metoprolol.


CONCLUSIONS
Patients taking beta-blockers did not have more hospital admissions or clinic visits for their asthma or COPD than patients not taking these agents. When clinically indicated, beta-blockers-especially atenolol-should be considered for patients with asthma or COPD.
Barnett
Mitchell J
MJ
Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City Veterans Administration Medical Center, University of Iowa, Iowa City, Iowa 52246, USA.
Milavetz
Gary
G
Kaboli
Peter J
PJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D014728:Veterans
D000319:Adrenergic beta-Antagonists