Economic Burden Of Comorbid Cardiovascular Disease (CVD) In Chronic Obstructive Pulmonary Disease (COPD) Patients In A Managed Care Population

Author(s):  
Anand A. Dalal ◽  
Manan Shah ◽  
Orsolya Lunacsek ◽  
Nicola A. Hanania
Author(s):  
Muhammad Shahid Iqbal ◽  
Fahad I. Al-Saikhan ◽  
Nehad J. Ahmed ◽  
Muhammad Zahid Iqbal

Introduction: Chronic obstructive pulmonary disease (COPD) imparts a substantial economic burden on an individual and society. Exacerbation of COPD (ECOPD) is the primary cost driver for this burden as it usually associated with hospital admissions of COPD patients. The present study aimed to determine the direct costs of acute ECOPD among COPD patients. Methods: A total of 90 eligible patients with acute ECOPD who were admitted to the hospital were involved in this study. A convenient sampling technique was used during data collection. Cost data were collected according to the expenditures and existing information. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0. The Spearman's rank test was used to observe the differences (correlations) between the Govt perspective and the patient perspective. Results: The direct costs per episode of acute ECOPD were determined according to the Anthonisen criteria for evaluating acute ECOPD. The mean direct costs for severity III, severity II and severity I were 89.1, 134.8 and 178.2 USD respectively. The cost of acute ECOPD was positively associated with disease severity, length of hospital stay and the number of co-morbidities. Conclusion: Acute ECOPD patients consume a considerable amount of healthcare resources and pose a significant economic burden on the government.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


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