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  • Title: The association between inhaled long-acting bronchodilators and less in-hospital care in newly-diagnosed COPD patients.
    Author: Kim J, Kim K, Kim Y, Yoo KH, Lee CK, Yoon HK, Kim YS, Park YB, Lee JH, Oh YM, Lee SD, Lee SW.
    Journal: Respir Med; 2014 Jan; 108(1):153-61. PubMed ID: 23993445.
    Abstract:
    BACKGROUND: Although the efficacy of inhaled long-acting bronchodilators has been well documented in randomised controlled studies, whether similar effects are obtained in real-life clinical practice is not clear. In this study, we analysed the effect of inhaled long-acting bronchodilators in newly-diagnosed COPD patients. METHODS: The Korean Health Insurance Review and Assessment Service databases were used. Participants ≥40-years-old who had not been diagnosed with COPD between 2007 and 2008 but were diagnosed and prescribed COPD medication in 2009 were designated as newly-diagnosed COPD patients. Patients were divided into three groups based on the use of bronchodilators, an inhaled long-acting bronchodilator (LA-B), an inhaled short-acting bronchodilator (SA-B) and an oral medication (OM) group. RESULTS: A total of 77,480 newly-diagnosed COPD patients with a mean age of 68.5 years, among which 43,530 (56.2%) were men, were included in the study. ER visits and hospitalisation were associated with SA-B group, male gender, older age, Medicaid coverage, tertiary healthcare centre visits and higher comorbidities. Multivariate analysis showed that the SA-B group was associated with more ER visits, recurrent ER visits, hospitalisation and recurrent hospitalisation (adjusted ORs [95% confidence intervals] = 4.32 [3.93-4.75], 6.19 [5.24-7.30], 5.04 [2.95-3.39], and 8.49 [7.67-9.39], respectively) compared with the LA-B group. Medical utilisation cost was also higher in the SA-B group. CONCLUSION: Inhaled long-acting bronchodilator use was associated with lower rates of hospitalisation, fewer ER visits and lower medical costs in newly-diagnosed COPD patients in real-life clinical practice.
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