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Published on: November 8, 2013
Comorbidities and medication burden in patients with chronic obstructive pulmonary disease attending pulmonary
Ben Noteboom1, Sue Jenkins, Andrew Maiorana
1School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia (Mr Noteboom, Drs Jenkins, Maiorana, and Hill, and Ms Ng); Physiotherapy Department, Royal Perth Hospital, Perth, Western Australia, Australia (Mr Noteboom); Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Perth, Western Australia, Australia (Mr Noteboom, Drs Jenkins and Hill, and Mss Cecins and Ng); Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia (Dr Jenkins and Ms Cecins); Cardiac Transplant and Advanced Heart Failure Service, Royal Perth Hospital, Perth, Western Australia, Australia (Dr Maiorana); and Community Physiotherapy Services, North Metropolitan Area Health Service, Perth, Western Australia, Australia (Ms Cecins).
Purpose:
Chronic obstructive pulmonary disease (COPD) is characterized by concomitant systemic manifestations and comorbidities such as cardiovascular disease. Little data exist on the prevalence of comorbidities and medication burden in people with COPD attending pulmonary rehabilitation (PR) programs in Australia. This study aimed to determine the prevalence of comorbidities and describe the type and number of medications reported in a sample of patients with COPD referred to PR.
Methods:
A retrospective audit was conducted on patients referred to PR over a 1-year period. Data were collected on patient demographics, disease severity, comorbidities, and medications by review of patient notes, physician referral, and self-reported medication use.
Results:
Data were available on 70 patients (forced expiratory volume in 1 second = 37.5 [26.0] % predicted). Ninety-six percent of patients had at least 1 comorbidity, and 29% had 5 or more. The most common comorbidities were associated with cardiovascular disease (64% of patients). Almost half of the sample was overweight or obese (49%). Prescription medication use was high, with 57% using between 4 and 7 medications, and 29% using 8 or more.
Conclusions:
Patients with COPD attending PR in Australia have high rates of comorbidity. The number of medications prescribed for these individuals is similar to that seen in other chronic disease states such as chronic heart failure. Pulmonary rehabilitation presents opportunities for clinicians to educate patients on self-management strategies for multiple comorbidities, review medication usage, and discuss strategies aimed at optimizing adherence with medication regimes.
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