Resource use study in COPD (RUSIC): A prospective study to quantify the effects of COPD exacerbations on health care resource use among COPD patients

J. Mark FitzGerald, Jennifer M. Haddon, Carole Bradley-Kennedy, Lisa Kuramoto, Gordon T. Ford, Susanne Arndt, John Axler, Spencer Barclay, John Bartlett, Kenneth Bayly, Ronald Bennett, Ira Bernstein, Edwin Brankston, Kenneth Chapman, Stephen Coyle, Tom Crichton, Gordon Dyck, Alan Faiers, Didier Fay, Stephen FieldGeorge Fox, Louis Marie Gauthier, William Gracey, Robert Hauptman, Paul Hernandez, Kay Ho, Victor Hoffstein, Subodh Kanani, Alan Kaplan, Pierre Leblanc, Alex Leung, Keith Lummack, S. F.Paul Man, Jean Marie Martel, Denis O'Donnell, Michael O'Mahony, Jean Pascal Ouellet, Walter Owsianik, Edward Papp, Kim Papp, Paul Piechota, Gerard Quinn, Mohunlall Soowamber, Chris Spirou, Pearce Wilcox, William Swales, Avery Teplinsky, Frances Tung, Barry Turchen, Douglas Tweel, Richard Tytus, Brian Zidel

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is increasing interest in health care resource use (HRU) in Canada, particularly in resources associated with acute exacerbations of chronic obstructive pulmonary disease (COPD). Objective: To identify HRU due to exacerbations of COPD. Methods: A 52-week, multicentre, prospective, observational study of HRU due to exacerbations in patients with moderate to severe COPD was performed. Patients were recruited from primary care physicians and respirologists in urban and rural centres in Canada. Results: In total, 524 subjects (59% men) completed the study. Their mean age was 68.2±9.4 years, with a forced expiratory volume in 1 s of 1.01±0.4 L. Patients had significant comorbidities. There were 691 acute exacerbations of COPD, which occurred in 53% of patients: 119 patients (23%) experienced one acute exacerbation, 70 patients (13%) had two acute exacerbations and 89 patients (17%) had three or more acute exacerbations. Seventy-five patients were admitted to hospital, with an average length of stay of 13.2 days. Fourteen of the patients spent time in an intensive care unit (average length of stay 5.6 days). Factors associated with acute exacerbations of COPD included lower forced expiratory volume in 1 s (P<0.001), high number of respiratory medications prescribed (P=0.037), regular use of oral corticosteroids (OCSs) (P=0.008) and presence of depression (P<0.001). Of the 75 patients hospitalized, only 53 received OCSs, four received referral for rehabilitation and 15 were referred for home care. Conclusions: The present study showed a high prevalence of COPD exacerbations, which likely impacted on HRU. There was evidence of a lack of appropriate management of exacerbations, especially with respect to use of OCSs, and referral for pulmonary rehabilitation and home care.

Original languageEnglish (US)
Pages (from-to)145-152
Number of pages8
JournalCanadian Respiratory Journal
Volume14
Issue number3
DOIs
StatePublished - Apr 2007

Keywords

  • Chronic obstructive pulmonary disease
  • Exacerbations
  • Health care resource use

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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