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Clinical, humanistic, and economic burden of chronic obstructive pulmonary disease (COPD) in Canada: a systematic
Tam Dang-Tan1, Afisi Ismaila2,3, Shiyuan Zhang4
1GlaxoSmithKline, 7333 Mississauga Road, Mississauga, ON, L5N 6L4, Canada. tam.x.dang-tan@gsk.com.
Insights
Chronic obstructive pulmonary disease (COPD) significantly impacts Canadians. Self-care, integrated care, and telephone support can reduce the clinical, humanistic, and economic burden of COPD for patients and society.
Area of Science:
- Pulmonary Medicine
- Health Economics
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) is a leading cause of death globally and in Canada.
- The clinical, humanistic, and economic burden of COPD necessitates updated evidence for healthcare professionals and policymakers.
Purpose of the Study:
- To systematically review recent evidence on the clinical, humanistic, and economic burden of COPD in Canada.
- To provide updated information for healthcare professionals and decision-makers regarding COPD management and impact.
Main Methods:
- A systematic literature search was conducted in PubMed, EMBASE, and Cochrane databases for studies published between January 2000 and December 2012.
- Searches focused on Canadian studies concerning COPD, including randomized controlled trials, observational studies, and systematic reviews/meta-analyses reporting on healthcare resource utilization, quality of life, and costs.
Main Results:
- 70 studies indicated significant COPD burden, including frequent healthcare visits (0-4 ED, 0.3-1.5 hospital, 0.7-5 physician annually).
- Self-care management, integrated care, and telephone support were associated with reduced emergency visits, hospitalizations, and physician visits.
- COPD negatively affects quality of life, with high inactivity (60-68%) and activity restrictions (60-72%). Average costs ranged from CAN $2444-4391 (patient) to CAN $3910-6693 (societal) per patient.
Conclusions:
- The clinical, humanistic, and economic burden of COPD in Canada is substantial.
- Interventions such as self-care management, integrated care, and telephone support show promise in mitigating the burden of COPD.
- Addressing COPD effectively can lead to significant benefits for Canadian patients and the healthcare system.
Background:
Chronic obstructive pulmonary disease (COPD) is a chronic, irreversible disease and a leading cause of worldwide morbidity and mortality. In Canada, COPD is the fourth leading cause of death. This systematic review was undertaken to update healthcare professionals and decision makers regarding the recent clinical, humanistic and economic burden evidence in Canada.
Methods:
A systematic literature search was conducted in PubMed, EMBASE, and Cochrane databases to identify original research published January 2000 through December 2012 on the burden of COPD in Canada. Each search was conducted using controlled vocabulary and key words, with "COPD" as the main search concept and limited to Canadian studies, written in English and involving human subjects. Selected studies included randomized controlled trials, observational studies and systematic reviews/meta-analyses that reported healthcare resource utilization, quality of life and/or healthcare costs.
Results:
Of the 972 articles identified through the literature searches, 70 studies were included in this review. These studies were determined to have an overall good quality based on the quality assessment. COPD patients were found to average 0-4 annual emergency department visits, 0.3-1.5 annual hospital visits, and 0.7-5 annual physician visits. Self-care management was found to lessen the overall risk of emergency department (ED) visits, hospitalization and unscheduled physician visits. Additionally, integrated care decreased the mean number of hospitalizations and telephone support reduced the number of annual physician visits. Overall, 60-68 % of COPD patients were found to be inactive and 60-72 % reported activity restriction. Pain was found to negatively correlate with physical activity while breathing difficulties resulted in an inability to leave home and reduced the ability to handle activities of daily living. Evidence indicated that treating COPD improved patients' overall quality of life. The average total cost per patient ranged between CAN $2444-4391 from a patient perspective to CAN $3910-6693 from a societal perspective. Furthermore, evidence indicated that COPD exacerbations lead to higher costs.
Conclusions:
The clinical, humanistic and economic burden of COPD in Canada is substantial. Use of self-care management programs, telephone support, and integrated care may reduce the overall burden to Canadian patients and society.
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