title: Prevalence and burden of dyspnoea among COPD patients in Japan.
abstract: OBJECTIVE
  Dyspnoea is the most common symptom of chronic obstructive pulmonary disease (COPD) significantly affecting activity, impairing patients' well-being and contributing to the economic burden of COPD. The objective of this study was to estimate the prevalence of dyspnoea and its impact on COPD management costs in Japan.
  
  
  METHODS
  A cross-sectional survey was conducted among 82 internal medicine physicians and 85 respiratory specialists representing 420 patients with COPD in Japan. Information was collected on demographic and clinical characteristics, dyspnoea (mMRC scale), and healthcare resource use. Dyspnoea prevalence was estimated among all patients and those on specific COPD treatments. The economic burden was derived from two cohorts based on their level of dyspnoea that were matched by propensity scores balancing their demographic and disease burden characteristics.
  
  
  RESULTS
  Moderate-severe dyspnoea (mMRC score ≥ 2) was reported by 37.5% of COPD patients and ranging from 21.5% among patients treated with a mono bronchodilator to 59.8% among patients treated with triple therapy. Descriptive analysis showed that dyspnoeic patients have higher annual costs attributable to consultations (€2999 vs. €1906), medications (€1139 vs. €716), exacerbations (€674 vs. €36), other resources (€1789 vs. €140) and in total (€6348 vs. €2797) (p < 0.0001 for all comparisons) compared to patients with mild or no dyspnoea (mMRC score < 2). The total costs remained significantly higher in a propensity-matched cohort adjusted for severity and cardiovascular comorbidity [€6776.1 vs. €4461.3, p = 0.0236].
  
  
  CONCLUSIONS
  Moderate-severe dyspnoea is common among consulting COPD patients in Japan and is a significant cost driver for the healthcare system.
authors.affiliation: Adelphi Real World, Macclesfield, UK.
authors.forename: M
authors.initials: M
authors.lastname: Small
authors.affiliation: Adelphi Real World, Macclesfield, UK.
authors.forename: T
authors.initials: T
authors.lastname: Holbrook
authors.affiliation: Adelphi Real World, Macclesfield, UK.
authors.forename: R
authors.initials: R
authors.lastname: Wood
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline R&D, Uxbridge, UK.
authors.forename: H
authors.initials: H
authors.lastname: Mullerova
authors.affiliation: Respiratory Medical, GlaxoSmithKline, Brentford, UK.
authors.forename: I
authors.initials: I
authors.lastname: Naya
authors.affiliation: Value Evidence and Outcomes, GlaxoSmithKline R&D, Brentford, UK.
authors.forename: Y S
authors.identifier: http://orcid.org/0000-0002-7531-1319
authors.initials: YS
authors.lastname: Punekar
mesh_terms: D000368:Aged; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome