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Medication changes prior to hospitalization for obstructive lung disease: a case-crossover study.
Karin J Velthove1, Hubert Gm Leufkens, René C Schweizer
1Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, The Netherlands.
The Annals of Pharmacotherapy
|January 15, 2010
Summary
Medication use, including respiratory drugs, systemic glucocorticoids, and antibiotics, increased before hospitalizations for obstructive lung disease. Early detection of exacerbations may help prevent future hospital admissions.
Area of Science:
- Pharmacoepidemiology
- Respiratory Medicine
- Health Services Research
Background:
- Hospitalizations are a key outcome in pharmacoepidemiology.
- Prehospital management and the period leading to hospitalization are critical.
- Understanding medication patterns before admission is essential for patient care.
Purpose of the Study:
- To analyze medication changes preceding hospitalization for obstructive lung disease.
- To quantify the link between medication use and hospitalization risk.
Main Methods:
- Case-crossover study design utilizing the PHARMO record linkage system.
- Inclusion of adult patients hospitalized for obstructive lung disease (2005-2007).
- Analysis of drug dispensing data and hospital admissions, assessing medication use in 90-day windows before hospitalization and control periods.
Main Results:
- Identified 1481 hospitalizations for obstructive lung disease.
- Observed increased respiratory medication use in the 90 days prior to hospitalization.
- Significant associations found between hospitalization and use of 3+ respiratory drugs (OR 2.2), systemic glucocorticoids (OR 4.5), and antibiotics (OR 3.1).
Conclusions:
- Increased use of systemic glucocorticoids, antibiotics, and respiratory drugs precedes hospitalization for obstructive lung disease.
- These medication patterns may indicate developing or treated exacerbations.
- Need for early exacerbation detection markers to enable timely treatment and potentially prevent hospitalizations.
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