scholarly journals A COST-EFFECTIVE ANALYSIS OF TIOTROPIUM WITH FORMOTEROL AND BUDESONIDE WITH FORMOTEROL BASED ON EFFICACY AND QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

Author(s):  
Kameswari Garnepudi ◽  
Ivaturi Shravanthi ◽  
Keerthana Sivakumar ◽  
Maithili Sharma M ◽  
Kurakula Manasa

Objectives: The primary objective of the study was to conduct the cost-effective analysis of tiotropium with formoterol versus budesonide with formoterol in the management of Stage-I chronic obstructive pulmonary disease (COPD) based on efficacy and quality of life (QoL). The study also aims to analyze the improvement of the QoL through pulmonary rehabilitation. The secondary objective was to evaluate the incidence of depression and anxiety in COPD patients.Methods: A prospective interventional study, with a sample size of 74 patients diagnosed with COPD Stage-I was conducted for 6 months. The study population was divided based on simple randomization into two main groups, one receiving tiotropium with formoterol and the other receiving budesonide with formoterol. Based on spirometry, their pulmonary function test (PFT) was recorded. The patients QoL was recorded using the WHOQoL-BREF questionnaire.Results: Data of 74 patients were collected for both the zero-degree and first-degree follow-up. The patients demonstrated good compliance with the transinhaler of the prescribed drugs. A significant improvement after providing pulmonary rehabilitation in PFT, i.e., forced expiratory volume1/ forced vital capacity values (p=0.000**) and the WHOQoL scoring (P = 0.001**) was observed in patients receiving tiotropium with formoterol. Tiotropium with formoterol was found to be more cost-effective treatment than budesonide with formoterol.Conclusion: The study showed that transinhalation of 9 mcg/12 mcg tiotropium/formoterol once a day is a better cost-effective treatment than 200 mcg/6 mcg transinhalation of budesonide/formoterol twice a day.

2003 ◽  
Vol 13 (3) ◽  
pp. 175-182 ◽  
Author(s):  
Dipankar Dutta ◽  
Richard JA Butland ◽  
Ruma R Dutta ◽  
Miriam C Casey

Pulmonary rehabilitation is a multidisciplinary education and exercise programme of care for patients with chronic respiratory disease, particularly Chronic Obstructive Pulmonary Disease (COPD). It aims to reduce symptoms, decrease disability, increase participation in physical and social activities and improve overall quality of life in patients who may still be very disabled despite optimal pharmacological treatment. Pulmonary rehabilitation first began more than 30 years ago and is now established as an important part of the management of COPD.


2020 ◽  
Vol 7 (1) ◽  
pp. e000548
Author(s):  
Derrick Lopez ◽  
Nola Cecins ◽  
Joanne Cockram ◽  
Anna Collins ◽  
Holly Landers ◽  
...  

IntroductionPulmonary rehabilitation is a core component of the treatment of people with chronic obstructive pulmonary disease (COPD); however, the benefits gained diminish in the ensuing months. The optimal strategy for maintaining the benefits is unclear with weekly supervised maintenance exercise programmes proposed as one strategy. However, the long-term future of maintenance programs is dependent on quality evidence.Methods and analysisThe ComEx3 randomised controlled trial will investigate the efficacy of extending a weekly supervised maintenance programme for an additional 6 months following an initial 10-week maintenance programme (intervention) by comparing with a control group who receive the same 10-week maintenance programme followed by 6 months of usual care. 120 participants with COPD will be recruited. Primary objective is to determine health-related quality of life over 12 months. Secondary objectives are to determine functional exercise capacity trajectory and to perform an economic evaluation of the intervention to the health system. Outcomes will be analysed for superiority according to intention-to-treat and per-protocol approaches.Ethics and disseminationApproval has been received from the relevant ethics committees. Findings will be disseminated in peer-reviewed journals and conferences, targeting those involved in managing people with COPD as well as those who develop policies and guidelines.Clinical trial registrationANZCTR 12618000933257


2011 ◽  
Vol 18 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Michael K Stickland ◽  
Tina Jourdain ◽  
Eric YL Wong ◽  
Wendy M Rodgers ◽  
Nicholas G Jendzjowsky ◽  
...  

BACKGROUND: Pulmonary rehabilitation (PR) is an effective therapeutic strategy to improve health outcomes in patients with chronic obstructive pulmonary disease (COPD); however, there is insufficient PR capacity to service all COPD patients, thus necessitating creative solutions to increase the availability of PR.OBJECTIVE: To examine the efficacy of PR delivered via Telehealth (Telehealth-PR) compared with PR delivered in person through a standard outpatient hospital-based program (Standard-PR).METHODS: One hundred forty-seven COPD patients participated in an eight-week rural PR program delivered via Telehealth-PR. Data were compared with a parallel group of 262 COPD patients who attended Standard-PR. Education sessions were administered two days per week via Telehealth, and patients exercised at their satellite centre under direct supervision. Standard-PR patients viewed the same education sessions in person and exercised at the main PR site. The primary outcome measure was change in quality of life as evaluated by the St George’s Respiratory Questionnaire (SGRQ). A noninferiority analysis was performed using both intention-to-treat and per-protocol approaches.RESULTS: Both Telehealth-PR and Standard-PR resulted in clinically and statistically significant improvements in SGRQ scores (4.5±0.8% versus 4.1±0.6%; P<0.05 versus baseline for both groups), and the improvement in SGRQ was not different between the two programs. Similarly, exercise capacity, as assessed by 12 min walk test, improved equally in both Telehealth-PR and Standard-PR programs (81±10 m versus 82±10 m; P<0.05 versus baseline for both groups).CONCLUSION: Telehealth-PR was an effective tool for increasing COPD PR services, and demonstrated improvements in quality of life and exercise capacity comparable with Standard-PR.


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