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Dual versus triple therapy in patients hospitalized for COPD in France: a claims data study

Title: Dual versus triple therapy in patients hospitalized for COPD in France: a claims data study
Authors: Dalon, Faustine; Roche, Nicolas; Belhassen, Manon; Nolin, Maeva; Pegliasco, Hervé; Deslée, Gaetan; Housset, Bruno; Devillier, Philippe; van Ganse, Eric
Contributors: PELyon, Pharmacoepidemiologie, Lyon; Mucoviscidose et bronchopathies chroniques : biopathologie et phénotypes cliniques (EA 2511); Hôpital Cochin AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5); Hôpital Européen Fondation Ambroise Paré - Marseille; Hôpital Maison Blanche; Hôpital universitaire Robert Debré Reims (CHU Reims); Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL); Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM); Institut Mondor de Recherche Biomédicale (IMRB); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Hôpital Foch Suresnes; Health Service and Performance Research (HESPER); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon; Laboratoire de Médecine Respiratoire HCL - Hôpital de la Croix Rousse, Lyon; Hôpital de la Croix-Rousse CHU - HCL; Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL); Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1); Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)
Source: ISSN: 1176-9106.
Publisher Information: CCSD; Dove Medical Press
Publication Year: 2019
Collection: Université de Reims Champagne-Ardenne: Archives Ouvertes (HAL)
Subject Terms: health care resource use; exacerbations; persistence; therapy; COPD; [SDV]Life Sciences [q-bio]
Description: International audience ; Purposes: Following a hospitalization for COPD, dual and triple therapies were compared in terms of persistence and relations with outcomes (exacerbations, health care resource use and costs). Methods: This was a historical observational database study. All patients aged ≥45 hospitalized for COPD between 2007 and 2015 were identified in a 1/97 th random sample of French claims data. Patients receiving dual therapy within 60 days after hospitalization were compared to patients receiving triple therapy, after propensity score matching on disease severity. Results: Of the 3,089 patients hospitalized for COPD, 1,538 (49.8%) received either dual or triple therapy in the 2 months following inclusion, and 1,500 (48.6%) had at least 30 days of follow-up available; 846 (27.4%) received dual therapy, and 654 (21.2%) received triple therapy. After matching, the number of exacerbations was 2.4 per year in the dual vs 2.3 in the triple group (p=0.45). Among newly treated patients (n=206), persistence at 12 months was similar in the dual and triple groups (48% vs 41%, respectively, p=0.37). As compared to patients on dual therapy, more patients on triple therapy received oral corticosteroids (49.1 vs 40.4%, p=0.003) or were hospitalized for any reason (67% vs 55.8%, p=0.0001) or for COPD (35.3 vs 25.1%, p=0.0002) during follow-up. Cost of care was higher for patients on triple than for those on dual therapy (€11,877.1 vs €9,825.1, p=0.01). Conclusion: Following hospitalizations for COPD, patients on dual and triple therapy experienced recurrent exacerbations, limited adherence to therapies and high cost of care. Patients on triple therapy appeared more severe than those on dual therapy, as reflected by exacerbations and health care resource use.
Document Type: article in journal/newspaper
Language: English
DOI: 10.2147/COPD.S214061
Availability: https://univ-reims.hal.science/hal-02448839; https://univ-reims.hal.science/hal-02448839v1/document; https://univ-reims.hal.science/hal-02448839v1/file/DalonFaustine_IntJCOPD_2019.pdf; https://doi.org/10.2147/COPD.S214061
Rights: https://about.hal.science/hal-authorisation-v1/ ; info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.F7D5E787
Database: BASE