title: Burden of Exacerbations in Patients with Moderate to Very Severe COPD in the Netherlands: A Real-life Study.
abstract: OBJECTIVE
  The objective of this study was to compare rates of different types of acute exacerbations of COPD (AECOPDs) and healthcare utilization among patients with different severities of COPD.
  
  
  METHODS
  Data for this study was obtained from the PHARMO Database Network, which includes drug dispensing records from pharmacies, hospitalization records and information from general practitioners. Patients with moderate to very severe COPD (GOLD II-III-IV) and a moderate or severe AECOPD between 2000 and 2010 were included in the study. Moderate and severe AECOPDs were defined by drug use and hospitalizations respectively. Study patients were followed from the first AECOPD to end of registration in PHARMO, death or end of study period, whichever occurred first. During follow-up, all recurrent AECOPDs were characterized and healthcare utilization was assessed.
  
  
  RESULTS
  Of 886 patients in the study, 52% had GOLD-II, 34% GOLD-III and 14% had GOLD-IV. The overall AECOPD recurrence rate per person year (PY) increased from 0.63 for patients with GOLD-II to 1.09 for patients with GOLD-III and 1.33 for patients with GOLD-IV. The rate of severe AECOPD was 0.06, 0.14 and 0.17 per PY, respectively.
  
  
  CONCLUSIONS
  AECOPD recurrence rates and healthcare utilization are significantly higher among patients with more severe COPD.
authors: 1PHARMO Institute , Utrecht , the Netherlands.
authors: Jetty A
authors: JA
authors: Overbeek
authors: Fernie J A
authors: FJ
authors: Penning-van Beest
authors: Maria-Magdalena
authors: MM
authors: Balp
authors: P N Richard
authors: PN
authors: Dekhuijzen
authors: Ron M C
authors: RM
authors: Herings
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D018450:Disease Progression; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000503:physiopathology*; D012008:Recurrence; D019141:Respiratory System Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D019141:Respiratory System Agents
keywords: AECOPD; GOLD; healthcare utilization; retrospective cohort study