Prevalence of chronic kidney diseases in patients with chronic obstructive pulmonary disease: assessment based on glomerular filtration rate estimated from creatinine and cystatin C levels

Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40–79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD—five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes.

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Effect of Pharmacy Counseling on Readmissions in Patients with Acute Exacerbations of COPD: A Randomized Controlled Trial

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.2021806 ◽

2021 ◽

Author(s):

Narachai Prasungriyo ◽

Nungruthai Sooksai

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Direct Costs ◽

Disease Assessment ◽

Chronic Obstructive ◽

P Value ◽

Intervention Period ◽

Obstructive Pulmonary Disease ◽

Significant Difference ◽

Acute Exacerbations

Objective: To investigate the effects of pharmacy counseling on clinical and economic outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients.Material and Methods: The outcomes consisted of 28-day hospital readmissions related to AECOPD, direct costs, medication adherence calculated by proportion of days covered (PDC), and health-related quality of life (HRQoL) measured by chronic obstructive pulmonary disease assessment test (CAT). The data derived from the intervention group, for which pharmacy counseling was provided, was compared with that obtained from the control group provided with usual pharmaceutical care. The study also drew comparisons between the PDC and CAT scores of pre- and postintervention periods.Results: Forty-four patients (23 intervention and 21 control) were included in the analysis. There were no significant differences in the readmission rate (13% vs 19%, p-value>0.050), nor the number of readmitted patients (3 vs 3, p-value >0.050). A decrease in direct costs did not reach statistical significance (p-value>0.050). In addition, no difference between the PDC scores was found (96.67 vs 100.00, p-value>0.050). Intervention patients obtained significantly lower CAT scores than the control patients did (9 vs 19, p-value<0.050). Compared with the pre-intervention period, PDC scores were identical; however, CAT scores measured during the post-intervention period were significantly different.Conclusion: Pharmacy counseling for AECOPD patients could enhance HRQoL. Drug therapy and pulmonary rehabilitation may cause such improvement. Further work, which has adequate participants, is required to detect a significant difference in readmissions between the two groups.

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