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Health care utilization history, GOLD guidelines, and respiratory medication prescriptions in patients with COPD.

Seaman J, Leonard AC, Panos RJ - Int J Chron Obstruct Pulmon Dis (2010)

Bottom Line: Prescribed treatments were compared with the GOLD guidelines and each patient was classified as receiving less medications than recommended in the guidelines (<G), medications according to the guidelines (=G), or more medications than recommended (>G).For GOLD stages 1 and 2, <G patients had the fewest and >G patients the most prior respiratory encounters during a 12 month period (0.31 +/- 0.073 (0.21, 0.47), 0.75 +/- 0.5 (0.37, 1.5), 1.1 +/- 0.27 (0.74, 1.6) visits/person/year, <G, =G, >G, respectively, mean + standard error of mean (SEM) (95% confidence limits) 2 degrees of freedom (df) ANOVA P < 0.001 for prescription effect).For GOLD stages 3 and 4, <G was associated with significantly fewer prior respiratory visits than was =G (0.78 +/- 0.11 (0.6, 1.0) and 2.4 +/- 0.47 (1.9, 3.1) visits/person/year, respectively, P < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Pulmonary, Critical Care, and Sleep Division, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA.

ABSTRACT

Background: The relationship between prior health care utilization and respiratory medication prescriptions in an unselected population of patients with COPD is not known.

Methods: We determined the prescribed respiratory medications and respiratory and nonrespiratory health care encounters in 523 Veterans with COPD at the Cincinnati Veterans Affairs Medical Center between 2000 and 2005. Prescribed treatments were compared with the GOLD guidelines and each patient was classified as receiving less medications than recommended in the guidelines (G).

Results: Respiratory medications were G for 14% of the patients studied. For GOLD stages 1 and 2, G patients the most prior respiratory encounters during a 12 month period (0.31 +/- 0.073 (0.21, 0.47), 0.75 +/- 0.5 (0.37, 1.5), 1.1 +/- 0.27 (0.74, 1.6) visits/person/year, G, respectively, mean + standard error of mean (SEM) (95% confidence limits) 2 degrees of freedom (df) ANOVA P < 0.001 for prescription effect). For GOLD stages 3 and 4, G respectively, 2 df ANOVA P = 0.096) or for GOLD stages 3 and 4 (3.6 +/- 0.25 (3.2, 4.1) and 4.0 +/- 0.44 (3.3, 4.9) visits/person/year,

Conclusions: Respiratory medications prescribed for an unselected population with a broad range of COPD severity complied poorly with the GOLD pharmacologic treatment guidelines but correlated with the number of prior respiratory health care visits.

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Related in: MedlinePlus

Frequency of yearly health care respiratory health care encounters per person during the 12 and 60 month periods.
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getmorefigures.php?uid=PMC2865029&req=5

f4-copd-5-089: Frequency of yearly health care respiratory health care encounters per person during the 12 and 60 month periods.

Mentions: The annualized frequency of prior respiratory encounters is presented in Figure 4. In the 12 month period, the majority of the patients (81%) had 3 or fewer respiratory encounters; 80.7% of all respiratory encounters occurred in 17.5% of the patients. In contrast, approximately two-thirds of patients (70%) had a respiratory encounter during the 60 month period. Approximately half of the patients (53.4%) had 1–5 respiratory encounters accounting for 39.7% of respiratory visits whereas 16.6% of patients had more than 5 encounters and accounted for 60.3% of all respiratory visits.


Health care utilization history, GOLD guidelines, and respiratory medication prescriptions in patients with COPD.

Seaman J, Leonard AC, Panos RJ - Int J Chron Obstruct Pulmon Dis (2010)

Frequency of yearly health care respiratory health care encounters per person during the 12 and 60 month periods.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2865029&req=5

f4-copd-5-089: Frequency of yearly health care respiratory health care encounters per person during the 12 and 60 month periods.
Mentions: The annualized frequency of prior respiratory encounters is presented in Figure 4. In the 12 month period, the majority of the patients (81%) had 3 or fewer respiratory encounters; 80.7% of all respiratory encounters occurred in 17.5% of the patients. In contrast, approximately two-thirds of patients (70%) had a respiratory encounter during the 60 month period. Approximately half of the patients (53.4%) had 1–5 respiratory encounters accounting for 39.7% of respiratory visits whereas 16.6% of patients had more than 5 encounters and accounted for 60.3% of all respiratory visits.

Bottom Line: Prescribed treatments were compared with the GOLD guidelines and each patient was classified as receiving less medications than recommended in the guidelines (<G), medications according to the guidelines (=G), or more medications than recommended (>G).For GOLD stages 1 and 2, <G patients had the fewest and >G patients the most prior respiratory encounters during a 12 month period (0.31 +/- 0.073 (0.21, 0.47), 0.75 +/- 0.5 (0.37, 1.5), 1.1 +/- 0.27 (0.74, 1.6) visits/person/year, <G, =G, >G, respectively, mean + standard error of mean (SEM) (95% confidence limits) 2 degrees of freedom (df) ANOVA P < 0.001 for prescription effect).For GOLD stages 3 and 4, <G was associated with significantly fewer prior respiratory visits than was =G (0.78 +/- 0.11 (0.6, 1.0) and 2.4 +/- 0.47 (1.9, 3.1) visits/person/year, respectively, P < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Pulmonary, Critical Care, and Sleep Division, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA.

ABSTRACT

Background: The relationship between prior health care utilization and respiratory medication prescriptions in an unselected population of patients with COPD is not known.

Methods: We determined the prescribed respiratory medications and respiratory and nonrespiratory health care encounters in 523 Veterans with COPD at the Cincinnati Veterans Affairs Medical Center between 2000 and 2005. Prescribed treatments were compared with the GOLD guidelines and each patient was classified as receiving less medications than recommended in the guidelines (G).

Results: Respiratory medications were G for 14% of the patients studied. For GOLD stages 1 and 2, G patients the most prior respiratory encounters during a 12 month period (0.31 +/- 0.073 (0.21, 0.47), 0.75 +/- 0.5 (0.37, 1.5), 1.1 +/- 0.27 (0.74, 1.6) visits/person/year, G, respectively, mean + standard error of mean (SEM) (95% confidence limits) 2 degrees of freedom (df) ANOVA P < 0.001 for prescription effect). For GOLD stages 3 and 4, G respectively, 2 df ANOVA P = 0.096) or for GOLD stages 3 and 4 (3.6 +/- 0.25 (3.2, 4.1) and 4.0 +/- 0.44 (3.3, 4.9) visits/person/year,

Conclusions: Respiratory medications prescribed for an unselected population with a broad range of COPD severity complied poorly with the GOLD pharmacologic treatment guidelines but correlated with the number of prior respiratory health care visits.

Show MeSH
Related in: MedlinePlus