RT Journal Article
SR Electronic
T1 Extent and impact of late vs early stage COPD diagnosis in the Swedish ARCTIC study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3933
DO 10.1183/13993003.congress-2016.PA3933
VO 48
IS suppl 60
A1 Kjell Åke Larsson
A1 Christer Janson
A1 Björn Ställberg
A1 Karin Lisspers
A1 Petter Olsson
A1 Konstantinos Kostikas
A1 Milica Uhde
A1 Leif Jorgensen
A1 Patrik Sobocki
A1 Gunnar Johansson
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3933.abstract
AB Background: Early chronic obstructive pulmonary disease (COPD) diagnosis may lead to improved disease management and reduced costs.Objective: To assess the clinical and economic impact of early vs late stage COPD diagnosis.Methods: Medical records data were collected from COPD patients in Swedish primary care centers and then linked to primary and secondary care national registries for prescriptions, deaths, hospital care and social characteristics data. Five years of data prior to patients' first COPD diagnosis were examined for early COPD signs i.e. pneumonia, respiratory diseases, use of oral corticosteroids, prescriptions for respiratory symptoms and spirometry measures. Patients were dichotomized as receiving either an early (ED; 0–2 early signs) or late (LD; ≥3 early signs) COPD diagnosis. A sensitivity analysis was conducted excluding patients with a comorbid asthma diagnosis pre-first COPD diagnosis.Results: 9,160 (72.2%) patients had a LD (mean age=69.4 yrs) and 3,537 (27.8%) had ED (mean age=68.8 yrs). LD was associated with higher prevalence of asthma (21.5% vs 3.5%, p<0.0001) and diabetes (10.0% vs 6.8%, p<0.0001). The exacerbation rate (HR 1.61 [95% CI 1.54, 1.69]) and prevalence of patients with frequent (>2/year) exacerbations (12.5% vs 5.0%, p<0.0001) was higher for LD patients. There was no mortality difference between LD and ED; however, excluding asthma patients, the mortality rate of LD was higher than that of ED (HR 1.10 [95% CI 1.02, 1.18]). LD was associated with higher direct costs per patient (12,000 EUR/yr vs 9,000 EUR/yr).Conclusion: Late COPD diagnosis is associated with increased COPD disease burden, comorbidities and costs.