Short- and Long-Term Impact of Prior Chronic Obstructive Pulmonary Disease Exacerbations on Healthcare Resource Utilization and Related Costs: An Observational Study (SHERLOCK)

Enrico de Nigris, John Haughney, Amanda J Lee, Mintu Nath, Hana Müllerová, Ulf Holmgren* (Corresponding Author), Bo Ding

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
2 Downloads (Pure)

Abstract

The observational retrospective cohort Study on HEalthcare Resource utiLization (HCRU) related to exacerbatiOns in patients with COPD (SHERLOCK; D5980R00014) evaluated exacerbation-related HCRU and costs using the U.K. National Health Service Greater Glasgow and Clyde Health Board data. Patients (≥40 years) with COPD were stratified by exacerbations one year before the index date: Group A (none), B (1 moderate), C (1 severe) and D (≥2 moderate and/or severe). All-cause and COPD-related HCRU and costs were assessed over 36 months. Adjusted rate ratios (RRs) or relative costs versus Group A were estimated using generalized linear models with appropriate distributions and link functions. The study included 22 462 patients (Group A, n = 7788; B, n = 5151; C, n = 250 and D, n = 9273). At 12 months, RRs (95% CI) versus Group A for all-cause and COPD-related HCRU, respectively, were highest in Groups C (1.28 [1.18, 1.39] and 1.18 [1.09, 1.29]) and D (1.26 [1.23, 1.28] and 1.29 [1.26, 1.31]). General practitioner and outpatient visits, and general ward stays/days accounted for the greatest COPD-related HCRU. All-cause and COPD-related relative costs (95% CI) versus Group A at 12 months, respectively, were 1.03 (0.94, 1.12) and 1.06 (0.99, 1.13) in Group B; 1.47 (1.07, 2.01) and 1.54 (1.20, 1.97) in Group C; 1.47 (1.36, 1.58) and 1.63 (1.54, 1.73) in Group D. Increased HCRU and costs in patients with exacerbation histories persisted at 36 months, demonstrating the sustained impact of exacerbations. The study suggests the importance of management and prevention of exacerbations through intervention optimization and budgeting by payers for exacerbation-related costs.
Original languageEnglish
Pages (from-to)92-100
Number of pages9
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume20
Issue number1
Early online date19 Dec 2022
DOIs
Publication statusPublished - 19 Dec 2023

Bibliographical note

Acknowledgments
Medical writing support, under the direction of the authors, was provided by Sara Cameron, MPhil, CMC Connect, a division of IPG Health Medical Communications, funded by AstraZeneca in accordance with Good Publication Practice (GPP 2022) guidelines [Citation28]. All authors were involved in the design and conduct of the study and in the interpretation of the data. All authors were involved in the writing of the manuscript and the final decision to submit to COPD: Journal of Chronic Obstructive Pulmonary Disease.

Funding
This study was sponsored by AstraZeneca. AstraZeneca authors were involved in the design of the study; in the analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.

Data Availability Statement

Supplemental data for this article can be accessed online at https://doi.org/10.1080/15412555.2022.2136065

Keywords

  • chronic obstructive pulmonary disease
  • exacerbation history
  • exacerbation severity
  • healthcare costs
  • healthcare resource utilization

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