Healthcare resource utilisation in patients with exacerbations of COPD and associated cardiovascular events: the...

The EXACOS-CV Canada study described and evaluated treatment patterns, healthcare resource utilisation (HCRU), and costs in patients with COPD who experienced a severe cardiovascular (CV) event or death preceded or not preceded by an exacerbation.

This longitudinal, retrospective cohort study included 142 787 individuals with COPD using administrative data from Alberta, Canada. The index event was a first hospitalisation for a CV event or all-cause death during follow-up. COPD-related treatment, HCRU and costs during the 12-month periods before and after the index events were described.

From the initial cohort, 43 564 (30.5%) patients with COPD experienced an index event; 15 100 (34.7%) had a COPD exacerbation in the 12 months prior. Patients whose index event was preceded (versus not preceded) by an exacerbation were dispensed higher amounts of COPD therapies in the 12 months prior (proportion of dual therapy: 36.9% versus 24.3%; proportion of triple therapy: 54.6% versus 16.3%) and 12 months following the CV event (proportion of dual therapy: 31.7% versus 27.4%; proportion of triple therapy: 53.4% versus 21.1%). Those with a preceding exacerbation also experienced higher rates of hospitalisations, emergency department admissions and general practitioner and specialist physician visits in both the 12 months prior to and following the index event.

Patients whose index events were preceded versus not preceded by an exacerbation received more treatment regimens and classes of COPD therapy but still incurred more HCRU. Despite the greater healthcare contacts, there remained large treatment gaps in this high-risk population.